Individual provider Active NPI

Jacqueline Ebel

  • Addiction (Substance Use Disorder) Counselor
  • Sheldon, IA
National Provider Identifier
1851906184
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
118 N 2ND Ave
Sheldon, IA 51201-1039
Phone
(712) 262-2922
NPI assigned
Sep 14, 2020
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

118 N 2ND Ave
Sheldon, IA 51201-1039

Mailing address

280 Heritage Park Rd
Primghar, IA 51245-1033
Phone (712) 441-2305

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
I20231106002872 IA Practitioner - Clinical Social Worker 8820445380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elevate Therapy and Assessment, PLLCGroup PAC ID 6709213507, 9 clinicians

Practice addresses (Care Compare)

604 Park St
Sheldon, IA 51201-1202
Phone (712) 338-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elevate Therapy & Assessment, PLLC CurrentSince Nov 1, 2023 Accepting new patients
Northwest Iowa Mental Health Center PastSince Sep 20, 2020 Accepting new patients
Northwest Iowa Mental Health Center PastSince Sep 20, 2020 Accepting new patients

Locations

604 Park St
Sheldon, IA 51201
Phone (712) 338-6200

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1851906184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 HERITAGE PARK RD",
            "city": "PRIMGHAR",
            "state": "IA",
            "postal_code": "512451033",
            "telephone_number": "712-441-2305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N 2ND AVE",
            "city": "SHELDON",
            "state": "IA",
            "postal_code": "512011039",
            "telephone_number": "712-262-2922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBEL",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheldon, IA

Sources for this page

Verify at the official NPI Registry.