NPIMap

Organization Active NPI

Mental Health Associates,LLC

  • Psychologist
  • Sioux City, IA
National Provider Identifier
1962551275
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
MENTAL HEALTH ASSOCIATES,LLC
Practice address
2212 Pierce St
Suite 100
Sioux City, IA 51104-3871
Phone
(712) 255-8323
Fax
(712) 255-8287
NPI assigned
Jan 9, 2007
Last updated
Feb 27, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Authorized official

Name
Denise Acker Marandola, PHDNPI 1376630277
Title
President
Phone
(712) 255-8323

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

2212 Pierce St
Suite 100
Sioux City, IA 51104-3871

Mailing address

2212 Pierce St
Suite 100
Sioux City, IA 51104-3871
Phone (712) 255-8323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031209001087 IA Part B Supplier - Clinic/Group Practice 0648176701 Receives reassigned benefits from 4 practitioners
Practice locations: Sioux City, IA

National Provider Directory

National Provider Directory

Locations

1502 Pierce St
Sioux City, IA 51105
Phone (712) 255-0502

2212 Pierce St
Ste 100
Sioux City, IA 51104
Phone (712) 255-8323

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393459200000",
    "number": "1962551275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 PIERCE ST",
            "address_2": "SUITE 100",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043871",
            "telephone_number": "712-255-8323",
            "fax_number": "712-255-8287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2212 PIERCE ST",
            "address_2": "SUITE 100",
            "city": "SIOUX CITY",
            "state": "IA",
            "postal_code": "511043871",
            "telephone_number": "712-255-8323",
            "fax_number": "712-255-8287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MENTAL HEALTH ASSOCIATES,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2014-02-27",
        "status": "A",
        "authorized_official_last_name": "MARANDOLA",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "ACKER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-255-8323",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.