Laura Elizabeth Probasco, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

091148 Issued in IA

Practice address

5406 Merle Hay Rd
Johnston, IA 50131-1209

Phone

(515) 727-8750

Fax

(515) 727-8757

NPI assigned

Aug 22, 2018

Last updated

Jun 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Laura Elizabeth Siddall Former name

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Capstone Behavioral Healthcare IncGroup PAC ID 0648169573, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Capstone Behavioral Healthcare, Inc

  • Community/Behavioral Health Agency
  • Newton, IA
  • NPI 1174598908
  Medicare reassignment Care Compare group NPD
• Eyerly Ball Community Mental Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Des Moines, IA
  • NPI 1982657490
  Medicare reassignment NPD
• Eyerly Ball Community Mental Health Services

  • Community Health Clinic/Center
  • Des Moines, IA
  • NPI 1598514895
  NPD
• Poweshiek County Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grinnell, IA
  • NPI 1528166360
  NPD (past)

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

{
    "created_epoch": "1534896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1639650344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5406 MERLE HAY RD",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311209",
            "telephone_number": "515-727-8750",
            "fax_number": "515-727-8757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBASCO",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "LISW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-22",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "091148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "SIDDALL",
            "middle_name": "ELIZABETH",
            "credential": "LISW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walker Porterfield, DC
• Mary Lee Powell, OTR/L
• Prestige Behavioral Care LLC
• Heather Nicole Prettyman, LMSW
• Colin Priest, LMHC, LMT, CRC
• Karla Prosperi, LMT
• Talia Pulley
• Jordan Pulliam
• Katie Jo Purcell, PT, DPT
• Sonu Puri-Hansen

• Clinical Social Worker in Johnston, IA
• Providers in Johnston, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.