Active NPI
Cody Soulinthavong
- Mental Health Counselor
- Clive, IA
National Provider Identifier
1821968496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 12247 Stratford Dr
Clive, IA 50325-8147 - Phone
- (515) 250-9811
- NPI assigned
- Nov 10, 2025
- Sex
- Unspecified or another gender identity
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IA | Primary |
Addresses
Primary practice location
12247 Stratford Dr
Clive, IA 50325-8147
Mailing address
3209 SE 4TH CT
Des Moines, IA 50315-2814
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1762732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762732800000",
"number": "1821968496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3209 SE 4TH CT",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503152814"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12247 STRATFORD DR",
"city": "CLIVE",
"state": "IA",
"postal_code": "503258147",
"telephone_number": "515-250-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOULINTHAVONG",
"first_name": "CODY",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-11-10",
"last_updated": "2025-11-10",
"certification_date": "2025-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clive, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.