Individual provider Active NPI

Dustin Ernberger, LMHC

  • Mental Health Counselor
  • North Liberty, IA
National Provider Identifier
1487684643
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00299 Issued in IA
Practice address
1290 Jordan St
North Liberty, IA 52317-8020
Phone
(319) 356-6352
Fax
(319) 358-2367
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 00299 IA Primary

Addresses

Primary practice location

1290 Jordan St
North Liberty, IA 52317-8020

Mailing address

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 356-6352

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208001728 IA Practitioner - Mental Health Counselor 4688023153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psychiatric Associates of Iowa, PCGroup PAC ID 9638550544, 50 clinicians

Practice addresses (Care Compare)

1290 Jordan St
North Liberty, IA 52317-8020
Phone (319) 432-0531

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00299IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatric Associates of Iowa, PC CurrentSince Jan 1, 2024 Accepting new patients
Psychiatric Associates of Iowa, PC CurrentSince Jan 1, 2024 Accepting new patients

Locations

1290 Jordan St
North Liberty, IA 52317
Phone (319) 356-6352

1900 Silver Lake Rd NW
Ste 110
Saint Paul, MN 55112
Phone (651) 379-1718

1900 Silver Lake Rd NW
Saint Paul, MN 55112
Phone (651) 379-1704

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1487684643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-356-6352",
            "fax_number": "319-358-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1290 JORDAN ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523178020",
            "telephone_number": "319-356-6352",
            "fax_number": "319-358-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERNBERGER",
        "first_name": "DUSTIN",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.