The Lodge Counseling & Consuliting

Primary specialty

CounselorTaxonomy code 101Y00000X

Legal business name

THE LODGE COUNSELING & CONSULITING

Practice address

705 Douglas St
Suite # 208
Sioux City, IA 51101-1048

Phone

(712) 259-5134

NPI assigned

Sep 1, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Vincent Mahon

Title

Co-Owner

Phone

(712) 259-5134

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1314835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314835200000",
    "number": "1629359872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 DOUGLAS ST",
            "address_2": "SUITE # 208",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011048",
            "telephone_number": "712-259-5134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 DOUGLAS ST",
            "address_2": "SUITE # 208",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511011048",
            "telephone_number": "712-259-5134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE LODGE COUNSELING & CONSULITING",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-01",
        "last_updated": "2011-09-01",
        "status": "A",
        "authorized_official_last_name": "MAHON",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "712-259-5134",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counselor in Sioux City, IA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2011; 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.