EMERALD BRIDGES FAMILY THERAPY, LLC (NPI# 1073966123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073966123 |
| Entity Type | Organization |
| Organization Name | EMERALD BRIDGES FAMILY THERAPY, LLC |
| Practice Address |
2349 Jamestown Ave Suite 5 Independence IA 50644-9709 |
| Mailing Address |
914 Oregon St Waterloo IA 50702-2509 |
| Practice Telephone | 5635791181 |
| Practice Fax Number | 3193321241 |
| Mailing Telephone | 5635791181 |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |
| Authorized Official Name | TARA NISSEN (MENTAL HEALTH THERAPIST) |
| Authorized Official Telephone | 5635791181 |
| Authorized Official Credential | LISW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
007613 | IA | Behavioral Health & Social Service Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | EMERALD BRIDGES FAMILY THERAPY, LLC | 2300 Swan Lake Blvd., Suite 102, Independence, IA 50644 |
| Street Address |
2349 JAMESTOWN AVE SUITE 5 |
| City | INDEPENDENCE |
| State | IA |
| Zip Code | 50644-9709 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265735872 | Lindsay Finnegan | Social Worker | 2349 Jamestown Ave, Suite 5, Independence, IA 50644-9709 | 2010-12-21 |
| 1659749596 | Mary Margaret Lynch | Counselor | 2349 Jamestown Ave, Independence, IA 50644-9709 | 2015-09-09 |
| 1730586876 | Cornerstone Family Therapy, LLC | Community/Behavioral Health | 2349 Jamestown Ave, Suite 5, Independence, IA 50644-9709 | 2014-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205476959 | Diane Meyer | Occupational Therapist | 230 Swan Lake Blvd, Suite 103, Independence, IA 50644 | 2020-01-10 |
| 1538717988 | Kathy Ann Allsup | Technician | 2617 Quasqueton Diag Blvd. #4, Independence, IA 50644 | 2019-08-29 |
| 1619182219 | Robert Thomas Kingus | Optometrist | 1310 1st St West, Independence, IA 50644 | 2007-05-14 |
| 1477646966 | Matthew Patrick Fuelling | Chiropractor | 231 2nd Ave N.e., Independence, IA 50644 | 2006-10-02 |
| 1104889609 | Sharla Kaye Wall | Chiropractor | 701 2nd Ave Ne, Independence, IA 50644 | 2006-04-07 |
| 1174053821 | Megan Rose Trembly | Speech-Language Pathologist | 1610 3rd St Ne, Independence, IA 50644 | 2017-06-15 |
| 1710432786 | Lauren Oldag | Social Worker | 2300 Swan Lake Blvd Ste 102, Independence, IA 50644 | 2016-08-19 |
| 1255781068 | Bradley Boyle | Optometrist | 1310 1st St W, Independence, IA 50644 | 2016-06-13 |
| 1528372968 | Thomas William Magner | Counselor | 417 5th St Nw, Independence, IA 50644-1554 | 2010-07-27 |
| 1093019796 | Linda Lee Moore | Community Health Worker | 1717 3rd St. N.e., Independence, IA 50644-1717 | 2011-01-10 |
| Find all providers in zip 50644 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184274730 | Nathan Andrew Reed | Social Worker | 4913 Downey Ave, Independence, MO 64055-5319 | 2019-09-16 |
| 1891344511 | Kathleen M Daley | Social Worker | 842 Ridgepoint Dr, Independence, KY 41051-8389 | 2019-09-05 |
| 1154970887 | Alejandra Quintana | Social Worker | 3737 S Elizabeth St Ste 100, Independence, MO 64057-1785 | 2019-09-05 |
| 1437614435 | Lakeysha Renee Fontenot | Social Worker | 3737 S Elizabeth St Ste 200, Independence, MO 64057-1785 | 2019-02-04 |
| 1356855407 | Ashley Knight | Social Worker | 6200 Rockside Woods Blvd N Ste 310, Independence, OH 44131-2343 | 2017-11-28 |
| 1639698368 | Jessica Ann Phillips-donnelly | Social Worker | 5001 Rockside Road, Crown Center II, Independence, OH 44131 | 2017-09-13 |
| 1205355252 | Counseling Services of Kansas, LLC | Social Worker | 201 N Penn Ave Ste 401, Independence, KS 67301-3354 | 2017-09-11 |
| 1184141202 | Stone and Bush Homes,llc | Social Worker | 12600 E 40 Hwy Ste 101, Independence, MO 64055-5909 | 2017-08-29 |
| 1861930141 | Elizabeth M Higgins | Social Worker | 15814 E 24 Hwy, Independence, MO 64050-2015 | 2017-02-07 |
| 1699212894 | Stacy Steely | Social Worker | 700 E College St, Independence, MO 64050-3145 | 2017-01-25 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 50644 |
Please comment or provide details below to improve the information on EMERALD BRIDGES FAMILY THERAPY, LLC.
| 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.