Active NPI
Kendall Fate, LMHC
- Mental Health Counselor
- Cedar Falls, IA
National Provider Identifier
1679658694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 00221
- Practice address
- 2802 Orchard Dr
Cedar Falls, IA 50613-5898 - Phone
- (319) 268-9700
- Fax
- (319) 268-1934
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 00221 | IA | Primary |
Addresses
Primary practice location
2802 Orchard Dr
Cedar Falls, IA 50613-5898
Mailing address
2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00221 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychiatric Associates of Northeast Iowa PC | Past | Accepting new patients | |
| Covenant Medical Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
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-
- Marriage & Family Therapist
- Waterloo, IA
- NPI 1457428112
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184284800000",
"number": "1679658694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2101 KIMBALL AVE",
"address_2": "LL14",
"city": "WATERLOO",
"state": "IA",
"postal_code": "507025063",
"telephone_number": "319-272-1590",
"fax_number": "319-272-1535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2802 ORCHARD DR",
"city": "CEDAR FALLS",
"state": "IA",
"postal_code": "506135898",
"telephone_number": "319-268-9700",
"fax_number": "319-268-1934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATE",
"first_name": "KENDALL",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "00221",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cedar Falls, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.