YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC (NPI# 1003979139) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003979139 |
| Entity Type | Organization |
| Organization Name | YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC |
| Practice Address |
301 Avenue M W Fort Dodge IA 50501-5623 |
| Practice Telephone | 5159554834 |
| Practice Fax Number | 5159556828 |
| Mailing Telephone | 5159554834 |
| Mailing Fax Number | 5159556828 |
| Enumeration Date | 2006-12-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. LAURENCE R MCLUCKIE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5159554834 |
| Authorized Official Credential | LMSW, MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | IA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 1153908 | 05 | |
| IA | 0466243 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC | 301 Avenue M W, Fort Dodge, IA 50501-5623 |
| Street Address |
301 AVENUE M W |
| City | FORT DODGE |
| State | IA |
| Zip Code | 50501-5623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346714201 | Nicole Jean Hoag | Counselor | 301 Avenue M W, Fort Dodge, IA 50501-5623 | 2019-01-14 |
| 1972741163 | Breanne Nnoko | Counselor | 301 Avenue M W, Fort Dodge, IA 50501-5623 | 2009-01-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023523412 | Katelin Judith Hartmann | Nurse Practitioner | 2913 5th Ave S, Fort Dodge, IA 50501 | 2017-12-06 |
| 1619338365 | John Clay Dds, Plc | Dentist | 1905 North 15th Street, Fort Dodge, IA 50501 | 2016-03-09 |
| 1710350517 | Alexandria Doyle | Nurse Practitioner | 800 Kenyon Road, Fort Dodge, IA 50501 | 2015-11-03 |
| 1366859993 | Heather Maureen Stillman Anderson | Dentist | 126 North 10th Street, Fort Dodge, IA 50501 | 2014-07-15 |
| 1205261575 | Iowa Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2029 5th Ave. South, Fort Dodge, IA 50501 | 2013-09-05 |
| 1952693020 | Riley Armstrong Plg & Htg, Inc | Contractor | 11 No. 20th St, Fort Dodge, IA 50501 | 2011-05-09 |
| 1407001639 | Marta Karyn Kramer | Pharmacist | 1428 2nd Ave No., Fort Dodge, IA 50501 | 2008-12-02 |
| 1427251305 | Andrew Bryant Sonksen | Dentist | 1716 1st Ave South, Fort Dodge, IA 50501 | 2007-06-07 |
| 1720127475 | John H Garton | Dentist | 1210 3rd Avenue South, Fort Dodge, IA 50501 | 2007-02-06 |
| 1912043746 | Aaron Mobley | Chiropractor | 1234 Central Ave, Fort Dodge, IA 50501 | 2007-01-29 |
| Find all providers in zip 50501 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719851 | Andrea Joan Ortner | Counselor | 211 Avenue M W, Fort Dodge, IA 50501-5789 | 2019-09-18 |
| 1710325204 | Carrie Cook | Counselor | 211 Avenue M West, Fort Dodge, IA 50501-5789 | 2013-06-06 |
| 1659922458 | Rebecca Anne Schuster | Counselor | 211 Avenue M West, Fort Dodge, IA 50501-5789 | 2019-09-23 |
| 1528442142 | Melissa Oatman | Counselor | 720 Kenyon Rd, Fort Dodge, IA 50501-5759 | 2015-07-14 |
| 1326487893 | Megan Jondle | Counselor | 726 S 17th St, Fort Dodge, IA 50501-5344 | 2013-06-18 |
| 1679911002 | Kelly Moore | Counselor | 726 S 17th St, Fort Dodge, IA 50501-5344 | 2013-06-07 |
| 1104264530 | Alyssa Pfantz | Counselor | 726 S 17th St, Fort Dodge, IA 50501-5344 | 2013-06-07 |
| 1285072611 | Craig Sosby | Counselor | 726 S 17th St, Fort Dodge, IA 50501-5344 | 2013-06-07 |
| 1548608979 | Ryan Walker | Counselor | 726 S 17th St, Fort Dodge, IA 50501-5344 | 2013-06-07 |
| 1750729182 | Barbara Newhart | Counselor | 726 S 17th St, Fort Dodge, IA 50501-5344 | 2013-06-07 |
| Find all providers in FORT DODGE | ||||
| City | FORT DODGE |
| Zip Code | 50501 |
Please comment or provide details below to improve the information on YOUTH SHELTER CARE OF NORTH CENTRAL IOWA INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.