Individual provider Active NPI

Krista Marie Lindholm, LISW

  • Clinical Social Worker
  • West Des Moines, IA
National Provider Identifier
1518328780
Registry record updated Jul 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
06426 Issued in IA
Practice address
6150 Village View Dr Ste 102
West Des Moines, IA 50266-5889
Phone
(515) 327-7036
Fax
(515) 875-4895
NPI assigned
Mar 15, 2016
Last updated
Jul 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 11096 IA
Clinical Social Worker 1041C0700X 06426 IA Primary

Addresses

Primary practice location

6150 Village View Dr Ste 102
West Des Moines, IA 50266-5889

Mailing address

6150 Village View Dr Ste 102
West Des Moines, IA 50266-5889
Phone (515) 327-7036

Other identifiers 1

IdentifierTypeStateIssuer
0223957MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11096IAMDAddiction (Substance Use Disorder) Counselor
06426IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Kalm Therapy Group PLLC Clinical CurrentSince Jul 27, 2020 Accepting new patients
Assessment Services Incorporated Addiction (Substance Use Disorder) CurrentSince Jul 27, 2020 Accepting new patients

Locations

440 Fairway Dr
Ste 200
West Des Moines, IA 50266
Phone (515) 327-7036

6150 Village View Dr
Ste 102
West Des Moines, IA 50266
Phone (515) 327-7036

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1458000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594857600000",
    "number": "1518328780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6150 VILLAGE VIEW DR STE 102",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665889",
            "telephone_number": "515-327-7036",
            "fax_number": "515-875-4895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6150 VILLAGE VIEW DR STE 102",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665889",
            "telephone_number": "515-327-7036",
            "fax_number": "515-875-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDHOLM",
        "first_name": "KRISTA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-15",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "11096",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "06426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0223957",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.