Individual provider Active NPI

Anetra Sherrard

  • Mental Health Counselor
  • Shenandoah, IA
National Provider Identifier
1609685791
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
115275 Issued in IA
Practice address
523 W Sheridan Ave
Shenandoah, IA 51601-1705
Phone
(712) 246-0159
NPI assigned
Jan 3, 2025
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 115275 IA Primary

Addresses

Primary practice location

523 W Sheridan Ave
Shenandoah, IA 51601-1705

Mailing address

523 W Sheridan Ave
Shenandoah, IA 51601-1705
Phone (712) 246-0159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250510000165 IA Practitioner - Mental Health Counselor 6800313065 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

523 W Sheridan Ave
Shenandoah, IA 51601-0115

PO Box
Suite 115
Shenandoah, IA 51601-0115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
115275IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Mental Health LLC Mental Health CurrentSince Feb 23, 2025 Accepting new patients

Locations

523 W Sheridan Ave
Shenandoah, IA 51601
Phone (712) 246-0159

600 W Sheridan Ave
Shenandoah, IA 51601
Phone (712) 246-0159

Organizations & group practices 1

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": "1735862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1609685791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 W SHERIDAN AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516011705",
            "telephone_number": "712-246-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 W SHERIDAN AVE",
            "city": "SHENANDOAH",
            "state": "IA",
            "postal_code": "516011705",
            "telephone_number": "712-246-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERRARD",
        "first_name": "ANETRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-03",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "115275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, IA

Sources for this page

Verify at the official NPI Registry.