Connie Lynn Popenhagen, MSW, LISW, ACADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

006928 Issued in IA

Practice address

905 Montgomery St
Decorah, IA 52101-2325

Phone

(563) 382-3649

Fax

(563) 382-8183

NPI assigned

Jul 25, 2007

Last updated

May 6, 2010By 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 2

Addresses

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Black Hawk-Grundy Mental Health Center IncGroup PAC ID 1850280363, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cpopenhagen1021727@direct.unitypoint.org

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.

• Black Hawk-Grundy Mental Health Center Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Waterloo, IA
  • NPI 1316944598
  Medicare reassignment Care Compare group NPD
• St Luke's Methodist Hospital

  • General Acute Care Hospital
  • Cedar Rapids, IA
  • NPI 1083708226
  NPD
• Northeast Iowa Mental Health Center

  dba Northeast Iowa Behavioral Health, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Decorah, IA
  • NPI 1710933445
  NPD (past)
• United Community Services, Inc.

  • Point of Service
  • West Des Moines, IA
  • NPI 1609998137
  NPD (past)

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1669662854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "905 MONTGOMERY ST",
            "address_2": "P.O. BOX 349",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-3649",
            "fax_number": "563-382-8183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 MONTGOMERY ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012325",
            "telephone_number": "563-382-3649",
            "fax_number": "563-382-8183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPENHAGEN",
        "first_name": "CONNIE",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "MSW, LISW, ACADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IA",
            "license": "09026",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "006928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter P. Appell, O.D.,P.C.
• Kathy L Petersburg, ARNP
• Cynthia B Peterson, MA, LISW
• Kayla Peterson
• David Liam Pittman, EMT
• Erin Marie Powers Daley, M.A., CADC
• Karla Mae Presler, LISW
• David A Prochaska, MS
• Max A Quaas, M.D.
• Stacey M Quam, OT

• Clinical Social Worker in Decorah, IA
• Providers in Decorah, 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 May 6, 2010; 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.