Seasons Center for Mental Health

Organization Active NPI Addiction (Substance Use Disorder) Counselor · Spencer, IA

NPI 1487900965 · NPPES record last updated Aug 2, 2012

Key facts

NPI
1487900965
Entity type
Organization (NPI type 2)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
05041 (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
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 9

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

National Provider Directory

Tax ID family
Northwest Mental HLTH C (10 organizations share this tax ID)

Interoperability endpoints

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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor
Group: 193200000X MULTI-SPECIALTY GROUP
101YA0400X 05041 IA Yes
Mental Health Counselor
Group: 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

Other providers in Spencer, IA

All providers in Spencer, IA · Addiction (Substance Use Disorder) Counselor in Iowa

Sources for this page

Verify at the official NPI Registry.