Heartland Family Service
Organization Active NPI Professional Counselor · Council Bluffs, IA
NPI 1710136841 · NPPES record last updated Aug 31, 2010
Key facts
- NPI
- 1710136841
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Professional Counselor 101YP2500X
- Legal business name
- HEARTLAND FAMILY SERVICE
- Practice address
- 1515 Avenue J
Council Bluffs, IA 51501-1170 - Phone
- (712) 322-1407
- NPI assigned
- Sep 12, 2008
- Organization subpart
- No
Authorized official
- Name
- John Jeanetta
- Title
- President / Ceo
- Phone
- (402) 552-7402
Other NPIs on the same Medicare enrollment 9
Corporate family (same tax ID) 20
Practitioners 4
-
Mary Lyn Oetter, MSW
-
Dianna Marie Prokupek, ARNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081218000069 | IA | Part B Supplier - Clinic/Group Practice | 7315833506 |
Receives reassigned benefits from 29 practitioners 9 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Logan, IA; Harlan, IA; Glenwood, IA; Council Bluffs, IA |
National Provider Directory
- Tax ID family
- Heartland Family Service
Locations
1515 Avenue J
Council Bluffs, IA 51501
Phone (712) 435-5350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor |
101YP2500X | Yes |
Addresses
Primary practice location
1515 Avenue J
Council Bluffs, IA 51501-1170
Mailing address
2101 S 42ND St
Omaha, NE 68105-2947
Other providers in Council Bluffs, IA
- Heartland Family Service
- Heartland Family Service
- Heartland Family Service
- Heartland Family Service
- Heartland Family Service
- Heartland Family Service
- Heartland Family Service
- Heartland Family Service
- Heartland Neurology PC
- Heartland Oncology & Hematology, PLLC
All providers in Council Bluffs, IA · Professional Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2010. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.