Innovative Family Therapy & Play Therapy Center LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

INNOVATIVE FAMILY THERAPY & PLAY THERAPY CENTER LLC

Practice address

409 N 4TH St Ste 108
Burlington, IA 52601-5255

Phone

(319) 759-9414

NPI assigned

Jan 22, 2019

Organization subpart

No

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

Authorized official

Name

Theresa Reckling, MA, LMFT, RPTNPI 1285977934

Title

Owner/LMFT

Phone

(319) 759-9414

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Theresa Reckling, LMFT

  • Marriage & Family Therapist
  • Burlington, IA
  • NPI 1285977934
  Medicare reassignment NPD Authorized official
• Alisa Nicole Smith, LISW

  • Social Worker
  • Burlington, IA
  • NPI 1619320645
  Medicare reassignment NPD
• Shea Dalton McCuen, T-LMHC

  • Mental Health Counselor
  • Burlington, IA
  • NPI 1770448565
  NPD
• Raegan Lynn Schulte

  • Mental Health Counselor
  • Burlington, IA
  • NPI 1932063955

  Single Specialty

  NPD
• Amanda Older, TLMHC

  • Mental Health Counselor
  • Burlington, IA
  • NPI 1689021974
  NPD (past)

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548115200000",
    "number": "1497219653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526010012",
            "telephone_number": "319-759-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 N 4TH ST STE 108",
            "city": "BURLINGTON",
            "state": "IA",
            "postal_code": "526015255",
            "telephone_number": "319-759-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE FAMILY THERAPY & PLAY THERAPY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-01-22",
        "status": "A",
        "authorized_official_last_name": "RECKLING",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "OWNER/LMFT",
        "authorized_official_telephone_number": "319-759-9414",
        "authorized_official_credential": "MA, LMFT, RPT"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Burlington, IA
• Providers in Burlington, IA by specialty
• Marriage & Family Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.