NPIMap

Organization Active NPI

Kanesville Therapy LLC

  • Mental Health Counselor
  • Council Bluffs, IA
National Provider Identifier
1760668768
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
00169 Issued in IA
Legal business name
KANESVILLE THERAPY LLC
Practice address
35 Main Place
Suite 100 Omni Center Business Park
Council Bluffs, IA 51503
Phone
(712) 328-9205
NPI assigned
Jan 21, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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

Authorized official

Name
Mrs. Carolyn Ann Andersen Burgher, MS LMHC LMHP LIMHPNPI 1053586206
Title
Mental Health Counselor
Phone
(712) 328-9205

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 00169 IA Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 1750 NE
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 376 NE

Addresses

Primary practice location

35 Main Place
Suite 100 Omni Center Business Park
Council Bluffs, IA 51503

Mailing address

16 Locust Lodge
Council Bluffs, IA 51503
Phone (712) 328-9205

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1200873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209340800000",
    "number": "1760668768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 LOCUST LODGE",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51503",
            "telephone_number": "712-328-9205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 MAIN PLACE",
            "address_2": "SUITE 100 OMNI CENTER BUSINESS PARK",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "51503",
            "telephone_number": "712-328-9205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KANESVILLE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-21",
        "last_updated": "2008-04-28",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN BURGHER",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "712-328-9205",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MS LMHC LMHP LIMHP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "00169",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1750",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "376",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.