Organization Active NPI

Growth & Grace Counseling and Consulting LLC

  • Mental Health Counselor
  • Waterloo, IA
National Provider Identifier
1720839418
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
GROWTH & GRACE COUNSELING AND CONSULTING LLC
Practice address
3261 University Ave
Waterloo, IA 50701-2051
Phone
(712) 789-0664
NPI assigned
Mar 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Authorized official

Name
Alycia Hemmen, LMHCNPI 1255734448
Title
Owner
Phone
(712) 789-0664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

3261 University Ave
Waterloo, IA 50701-2051

Mailing address

PO Box 71602
Clive, IA 50325-0602
Phone (515) 243-2057

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240513002151 IA Part B Supplier - Clinic/Group Practice 1850732561 Receives reassigned benefits from 2 practitioners
Practice locations: Waterloo, IA

National Provider Directory

National Provider Directory

Locations

3261 University Ave
Waterloo, IA 50701
Phone (319) 239-8522

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1720839418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71602",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503250602",
            "telephone_number": "515-243-2057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 UNIVERSITY AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012051",
            "telephone_number": "712-789-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROWTH & GRACE COUNSELING AND CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "HEMMEN",
        "authorized_official_first_name": "ALYCIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-789-0664",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.