Organization Active NPI

Theodore R. Liautaud

Doing business as Lakes Counseling & Psychiatry

  • Mental Health Counselor
  • Lake View, IA
National Provider Identifier
1487779575
Registry record updated Sep 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
01790 Issued in IA
Legal business name
THEODORE R. LIAUTAUD
Doing business as
Lakes Counseling & Psychiatry
Practice address
421 E Shore Dr
Lake View, IA 51450
Phone
(712) 657-2211
Fax
(712) 657-2106
NPI assigned
Mar 20, 2007
Last updated
Sep 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2008

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

Authorized official

Name
Theodore R. Liautaud, DO
Title
Owner
Phone
(712) 657-2211

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 01790 IA Primary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 01790 IA

Addresses

Primary practice location

421 E Shore Dr
Lake View, IA 51450

Mailing address

PO Box 710
421 E Shore Dr
Lake View, IA 51450
Phone (712) 657-2211

Other names 1

  • Lakes Counseling & Psychiatry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222732800000",
    "number": "1487779575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 710",
            "address_2": "421 E SHORE DR",
            "city": "LAKE VIEW",
            "state": "IA",
            "postal_code": "51450",
            "telephone_number": "712-657-2211",
            "fax_number": "712-657-2106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 E SHORE DR",
            "city": "LAKE VIEW",
            "state": "IA",
            "postal_code": "51450",
            "telephone_number": "712-657-2211",
            "fax_number": "712-657-2106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORE R. LIAUTAUD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-09-30",
        "status": "A",
        "authorized_official_last_name": "LIAUTAUD",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-657-2211",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "01790",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "01790",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lakes Counseling & Psychiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake View, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.