Jessica Renee Dvorak
Individual provider Active NPI Mental Health Counselor · Anamosa, IA
NPI 1992472252 · NPPES record last updated Aug 4, 2022
Key facts
- NPI
- 1992472252
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 209 W Main St
Anamosa, IA 52205-1811 - Phone
- (319) 774-2045
- Fax
- (866) 496-4073
- NPI assigned
- Aug 25, 2021
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2240 9TH St
Coralville, IA 52241-1507
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260401001078 | IA | Practitioner - Mental Health Counselor | 0749765345 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
209 W Main St
Anamosa, IA 52205-1811
Mailing address
3625 Utica Ridge Rd Ste B
Bettendorf, IA 52722-1653
Other practice location 1
3625 Utica Ridge Rd Ste B
Bettendorf, IA 52722-1653
Phone (877) 878-6606
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://lifeconnections.kasa-solutions.com/index.php | Health Information Exchange (HIE) |
Other providers in Anamosa, IA
- Brenda Deal
- Debra K. Oldham DDS PC
- Misti Deutschle
- Thomas J Devaney
- Marc N Duncan
- Empower U Living LLC
- Megan Engen
- Josiah T Ertz
- Aspen Felton
- Dara Flecksing
All providers in Anamosa, IA · Mental Health Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.