Individual provider Active NPI

Kari Stearns-Lamb

  • Mental Health Counselor
  • Davenport, IA
National Provider Identifier
1831565290
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
078821 Issued in IA
Practice address
1441 W Central Park Ave
Davenport, IA 52804-1707
Phone
(563) 383-1900
Fax
(563) 884-4638
NPI assigned
Aug 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 149019131 IL
Mental Health Counselor 101YM0800X 078821 IA Primary

Addresses

Primary practice location

1441 W Central Park Ave
Davenport, IA 52804-1707

Mailing address

1225 E River Dr Ste 205
Davenport, IA 52803-5752
Phone (309) 781-4053

Other identifiers 1

IdentifierTypeStateIssuer
149019131OtherILILLINOIS LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170426000860 IA Practitioner - Clinical Social Worker 4587941737 Reassigns benefits to 1 organization
I20170426002884 IL Practitioner - Clinical Social Worker 4587941737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1225 E River Dr
Suite 205
Davenport, IA 52803-5752
Phone (309) 781-4053

1718 8TH Ave
Unit 6
Moline, IL 61265-2118
Phone (309) 781-4053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078821IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Revolution Counseling Services LLC CurrentSince Jan 1, 2019 Accepting new patients

Locations

601 Brady St
Ste 204
Davenport, IA 52803
Phone (309) 781-4053

1225 E River Dr
Ste 205
Davenport, IA 52803
Phone (309) 781-4053

1718 8th Ave
Unit 6
Moline, IL 61265
Phone (309) 781-4053

Organizations & group practices 1

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": "1439942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1831565290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 E RIVER DR STE 205",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035752",
            "telephone_number": "309-781-4053",
            "fax_number": "309-792-2440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 W CENTRAL PARK AVE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528041707",
            "telephone_number": "563-383-1900",
            "fax_number": "563-884-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEARNS-LAMB",
        "first_name": "KARI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-19",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "149019131",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "078821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "149019131",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

Verify at the official NPI Registry.