Adonica Hennessy
Individual provider Active NPI Counselor · Marengo, IA
NPI 1699219857 · NPPES record last updated Dec 7, 2016
Key facts
- NPI
- 1699219857
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 081352 (IA)
- Practice address
- 1061 Court Ave
Marengo, IA 52301-1439 - Phone
- (319) 361-6529
- NPI assigned
- Dec 7, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Sac and Fox of the Miss in Iowa
Practice addresses (Care Compare)
1646 305TH St
Tama, IA 52339-9679
Phone (641) 484-4094
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230406000800 | IA | Practitioner - Clinical Social Worker | 1355716242 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sac & Fox of the Miss in Iowa | Current |
Accepting new patients | |
| Grace C Mae Advocate Center | Past | Accepting new patients |
Locations
1646 305th St
Ste A
Tama, IA 52339
Phone (641) 484-4094
1646 305th St
Tama, IA 52339
Phone (641) 484-4094
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 081352 | IA | Yes |
Addresses
Primary practice location
1061 Court Ave
Marengo, IA 52301-1439
Mailing address
2501 S Center St
Marshalltown, IA 50158-4562
Phone (319) 361-6529
Other providers in Marengo, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.