NPIMap

Organization Active NPI

Seasons Center for Mental Health

  • Addiction (Substance Use Disorder) Counselor
  • Spencer, IA
National Provider Identifier
1487900965
Registry record updated Aug 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
05041 Issued in IA
Legal business name
SEASONS CENTER FOR MENTAL HEALTH
Practice address
201 E 11TH St
Spencer, IA 51301-4436
Phone
(800) 242-5101
Fax
(712) 264-3177
NPI assigned
Aug 2, 2012
Last updated
Aug 2, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2012

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

Authorized official

Name
Mrs. Brenna A. Koedam, LMHC, IADCNPI 1437409281
Title
Substance Abuse Services Supervisor
Phone
(800) 242-5101

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 05041 IA Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 001530 IA

Addresses

Primary practice location

201 E 11TH St
Spencer, IA 51301-4436

Mailing address

201 E 11TH St
Spencer, IA 51301-4436
Phone (800) 242-5101

National Provider Directory

National Provider Directory
Tax ID family
Northwest Mental HLTH C10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/ed13fa1e-5e6c-45da-822a-ab9435740c2e/

Practitioners & affiliated clinicians

Practitioners 1

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": "1343865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343865600000",
    "number": "1487900965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 11TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014436",
            "telephone_number": "800-242-5101",
            "fax_number": "712-264-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 11TH ST",
            "city": "SPENCER",
            "state": "IA",
            "postal_code": "513014436",
            "telephone_number": "800-242-5101",
            "fax_number": "712-264-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASONS CENTER FOR MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-02",
        "last_updated": "2012-08-02",
        "status": "A",
        "authorized_official_last_name": "KOEDAM",
        "authorized_official_first_name": "BRENNA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SUBSTANCE ABUSE SERVICES SUPERVISOR",
        "authorized_official_telephone_number": "800-242-5101",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC, IADC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "05041",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001530",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2012; 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.