Individual provider Active NPI

Sunnycho Teeling

  • Mental Health Counselor
  • Waverly, IA
National Provider Identifier
1760094452
Registry record updated Aug 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
79161 Issued in TX
Practice address
408 W Bremer Ave
Waverly, IA 50677-3153
Phone
(319) 435-1859
NPI assigned
Aug 23, 2020
Last updated
Aug 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2020

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 79161 TX Primary

Addresses

Primary practice location

408 W Bremer Ave
Waverly, IA 50677-3153

Mailing address

501 Water St
Sumner, IA 50674-1555
Phone (319) 327-3484

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sunnycho@theinterconnectedjourney.com

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
I20240104000235 IA Practitioner - Mental Health Counselor 6901257948 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
79161TXMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Allen Memorial Hospital Corporation CurrentSince Jan 1, 2024 Accepting new patients
The Interconnected Journey Mental Health Current Accepting new patients
Allen Memorial Hospital Corporation CurrentSince Jan 1, 2024 Accepting new patients

Locations

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

212 W Dale St
Ste 102
Waterloo, IA 50703
Phone (319) 226-2345

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": "1598140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598140800000",
    "number": "1760094452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 WATER ST",
            "city": "SUMNER",
            "state": "IA",
            "postal_code": "506741555",
            "telephone_number": "319-327-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 W BREMER AVE",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506773153",
            "telephone_number": "319-435-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEELING",
        "first_name": "SUNNYCHO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-23",
        "last_updated": "2020-08-23",
        "certification_date": "2020-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "79161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sunnycho@theinterconnectedjourney.com",
            "affiliation": "N",
            "address_1": "408 W Bremer Ave",
            "city": "Waverly",
            "state": "IA",
            "country_code": "US",
            "postal_code": "506773153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

Verify at the official NPI Registry.