Individual provider Active NPI

Adonica Hennessy

  • Counselor
  • Marengo, IA
National Provider Identifier
1699219857
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
081352 Issued in IA
Practice address
1061 Court Ave
Marengo, IA 52301-1439
Phone
(319) 361-6529
NPI assigned
Dec 7, 2016
Last updated
Dec 7, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 081352 IA Primary

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

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230406000800 IA Practitioner - Clinical Social Worker 1355716242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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 IowaGroup PAC ID 6507806239, 11 clinicians

Practice addresses (Care Compare)

1646 305TH St
Tama, IA 52339-9679
Phone (641) 484-4094

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081352IAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Sac & Fox of the Miss in Iowa CurrentSince Jan 1, 2023 Accepting new patients
Grace C Mae Advocate Center Past Accepting new patients

Locations

1646 305th St
Tama, IA 52339
Phone (641) 484-4094

1646 305th St
Ste A
Tama, IA 52339
Phone (641) 484-4094

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1699219857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 S CENTER ST",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501584562",
            "telephone_number": "319-361-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 COURT AVE",
            "city": "MARENGO",
            "state": "IA",
            "postal_code": "523011439",
            "telephone_number": "319-361-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNESSY",
        "first_name": "ADONICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IA",
            "license": "081352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marengo, IA

Sources for this page

Verify at the official NPI Registry.