Individual provider Active NPI

Tiffany E Sumrall, LMHC

  • Mental Health Counselor
  • Newton, IA
National Provider Identifier
1730734187
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
110038 Issued in IA
Practice address
1123 1St Ave E Ste 200
Newton, IA 50208-3981
Phone
(641) 792-4012
NPI assigned
Aug 2, 2019
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 110038 IA Primary

Addresses

Primary practice location

1123 1St Ave E Ste 200
Newton, IA 50208-3981

Mailing address

1110 Caitlin Dr SE
Bondurant, IA 50035-2303
Phone (515) 300-6563

Other practice location 1

1220 NE Station Xing Ste 114
Grimes, IA 50111-8013
Phone (515) 380-6516

Other names 1

  • Tiffany Heth Former name

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
I20240226000639 IA Practitioner - Mental Health Counselor 6002251402 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110038IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Capstone Behavioral Healthcare, Inc CurrentSince Jan 13, 2024 Accepting new patients
Pink Couch Wellness PastSince May 14, 2023 Accepting new patients
Poweshiek County Mental Health Center PastSince Jan 13, 2024 Accepting new patients

Locations

200 4th Ave W
Grinnell, IA 50112
Phone (641) 236-6137

1123 1st Ave E
Ste 200
Newton, IA 50208
Phone (641) 792-4012

Organizations & group practices 3

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": "1564704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1730734187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 CAITLIN DR SE",
            "city": "BONDURANT",
            "state": "IA",
            "postal_code": "500352303",
            "telephone_number": "515-300-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1123 1ST AVE E STE 200",
            "city": "NEWTON",
            "state": "IA",
            "postal_code": "502083981",
            "telephone_number": "641-792-4012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1220 NE Station Xing Ste 114",
            "address_purpose": "LOCATION",
            "city": "Grimes",
            "state": "IA",
            "postal_code": "501118013",
            "country_code": "US",
            "telephone_number": "515-380-6516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUMRALL",
        "first_name": "TIFFANY",
        "middle_name": "E",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-02",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "110038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "HETH",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newton, IA

Sources for this page

Verify at the official NPI Registry.