Individual provider Active NPI

Samuel Barker Pattison, LMHCP

  • Mental Health Counselor
  • West Des Moines, IA
National Provider Identifier
1790459170
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
107654 Issued in IA
Practice address
2700 University Ave Ste 308
West Des Moines, IA 50266-1470
Phone
(402) 807-3666
NPI assigned
Aug 9, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 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 107654 IA Primary

Addresses

Primary practice location

2700 University Ave Ste 308
West Des Moines, IA 50266-1470

Mailing address

2700 University Ave Ste 308
West Des Moines, IA 50266-1470
Phone (402) 807-3666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 12, 2025 through Dec 12, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107654IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Choices Therapy Services, LLC PastSince Aug 1, 2021 Accepting new patients
Choices Therapy Services, LLC Mental Health PastSince Aug 1, 2021 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1790459170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY AVE STE 308",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661470",
            "telephone_number": "402-807-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 UNIVERSITY AVE STE 308",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661470",
            "telephone_number": "402-807-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTISON",
        "first_name": "SAMUEL",
        "middle_name": "BARKER",
        "credential": "LMHCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-09",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "107654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

Verify at the official NPI Registry.