NPIMap

Organization Active NPI

Clear Brook Counseling Professionals, LLC

  • Clinical Social Worker
  • Ames, IA
National Provider Identifier
1619350782
Registry record updated Apr 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07985 Issued in IA
Legal business name
CLEAR BROOK COUNSELING PROFESSIONALS, LLC
Practice address
1525 Airport Rd Ste 101
Ames, IA 50010-8231
Phone
(515) 292-3041
NPI assigned
Jul 7, 2015
Last updated
Apr 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2023

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

Authorized official

Name
Ms. Jamie L Pfantz
Title
Manager
Phone
(515) 292-3041

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 00800 IA
Mental Health Counselor 101YM0800X 00299 IA
Mental Health Counselor 101YM0800X 03167 IA
Clinical Social Worker 1041C0700X 07617 IA
Clinical Social Worker 1041C0700X 07985 IA Primary
Marriage & Family Therapist 106H00000X 00405 IA

Addresses

Primary practice location

1525 Airport Rd Ste 101
Ames, IA 50010-8231

Mailing address

614 Billy Sunday Rd Ste 100
Ames, IA 50010-8048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230614000958 IA Part B Supplier - Clinic/Group Practice 7113385741 Receives reassigned benefits from 3 practitioners
Practice locations: Ames, IA

National Provider Directory

National Provider Directory

Locations

1525 Airport Rd
Ste 101
Ames, IA 50010
Phone (515) 292-3023

614 Billy Sunday Rd
Ste 100
Ames, IA 50010
Phone (515) 337-0480

Practitioners & affiliated clinicians

Practitioners 9

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": "1436227200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681430400000",
    "number": "1619350782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 BILLY SUNDAY RD STE 100",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500108048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 AIRPORT RD STE 101",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500108231",
            "telephone_number": "515-292-3041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR BROOK COUNSELING PROFESSIONALS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-07",
        "last_updated": "2023-04-14",
        "certification_date": "2023-04-14",
        "status": "A",
        "authorized_official_last_name": "PFANTZ",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "515-292-3041",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00800",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00299",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "03167",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "07617",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "07985",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IA",
            "license": "00405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2023; 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.