Individual provider Active NPI

Logan Scott Wierschke, T-LMHC

  • Counselor
  • Waterloo, IA
National Provider Identifier
1700763000
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
133843 Issued in IA
Practice address
212 W Dale St # 100
Waterloo, IA 50703-1954
Phone
(319) 235-3550
NPI assigned
Aug 19, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 133843 IA Primary

Addresses

Primary practice location

212 W Dale St # 100
Waterloo, IA 50703-1954

Mailing address

297 Fast LN
Cedar Falls, IA 50613-2174
Phone (515) 491-1994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: No
  • 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
I20251009000409 IA Practitioner - Mental Health Counselor 8527565183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Kansas City, MO 64184

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Memorial Hospital Corporation CurrentSince Aug 11, 2025 Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Aug 11, 2025 Accepting new patients

Locations

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

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.

NPI Registry JSON

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

{
    "created_epoch": "1755561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1700763000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 FAST LN",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506132174",
            "telephone_number": "515-491-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W DALE ST # 100",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507031954",
            "telephone_number": "319-235-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIERSCHKE",
        "first_name": "LOGAN",
        "middle_name": "SCOTT",
        "credential": "T-LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-19",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "IA",
            "license": "133843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

Verify at the official NPI Registry.