LARISSA BUSTAMANTE (NPI# 1053861260) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053861260 |
| Entity Type | Individual |
| Full Name | LARISSA BUSTAMANTE |
| Practice Address |
3812 Ingersoll Ave Ste 100 Des Moines IA 50312-3400 |
| Mailing Address |
3812 Ingersoll Ave #100 Des Moines IA 50312 |
| Practice Telephone | 5152552500 |
| Mailing Telephone | 5152552500 |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
083876 | IA | Behavioral Health & Social Service Providers |
| Street Address |
3812 INGERSOLL AVE STE 100 |
| City | DES MOINES |
| State | IA |
| Zip Code | 50312-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544267 | Cheryl Denice Hayes | Social Worker | 3812 Ingersoll Ave Ste 100, Des Moines, IA 50312-3400 | 2020-09-24 |
| 1073173936 | Jason Brian Hunt | Social Worker | 3812 Ingersoll Ave Ste 100, Des Moines, IA 50312-3400 | 2019-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942837976 | Devon Anderson | Student in an Organized Health Care Education/Training Program | Des Moines University Pa Program, 3200 Grand, Des Moines, IA 50312 | 2020-03-27 |
| 1578190583 | Christian Ostrander | Student in an Organized Health Care Education/Training Program | Des Moines University-pa Program 3200 Grand Avenue, Des Moines, IA 50312 | 2020-03-27 |
| 1194209312 | Margaret Dedecker | Speech-Language Pathologist | 644 24th St., Des Moines, IA 50312 | 2018-09-24 |
| 1942702410 | Nelson-kirby Therapy & Consulting Services, LLC | Marriage & Family Therapist | 3900 Ingersoll Avenue Suite 108, Des Moines, IA 50312 | 2018-03-01 |
| 1851839864 | Lawrence Scanlon | Counselor | 412 42nd St, Des Moines, IA 50312 | 2017-02-09 |
| 1104275122 | Melissa Joshel | Social Worker | 2116 Grand Ave Ste 2, Des Moines, IA 50312 | 2016-06-09 |
| 1629435813 | Abby Michele Miller | Acupuncturist | 531 40th Street, Des Moines, IA 50312 | 2016-01-20 |
| 1326410689 | Dawn Theresa Corriere | Advanced Practice Midwife | 3714 Ingersoll Ave, Des Moines, IA 50312 | 2015-10-27 |
| 1336558154 | Paul Johnston | Counselor | 600 42nd Street, Des Moines, IA 50312 | 2014-08-06 |
| 1083847214 | Mark David Ravreby | Internal Medicine | 3663 Grand Ave, #204, Des Moines, IA 50312 | 2009-09-04 |
| Find all providers in zip 50312 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154922557 | Forward Consulting LLC | Counselor | 4309 University Ave, Des Moines, IA 50311-3423 | 2020-11-03 |
| 1104424779 | Marissa Schuster-ramirez | Counselor | 1611 31st St, Des Moines, IA 50311-2809 | 2020-10-15 |
| 1396399978 | Jenny Erdman | Counselor | 2209 36th St, Des Moines, IA 50310-4408 | 2019-07-31 |
| 1568023182 | Infinity Assessment Services LLC | Counselor | 100 E Euclid Ave Ste 131, Des Moines, IA 50313-4540 | 2019-06-25 |
| 1932763521 | Choices Therapy Services, LLC | Counselor | 3805 Lower Beaver Rd, Des Moines, IA 50310-4708 | 2019-04-29 |
| 1427531987 | David Higdon | Counselor | 6000 Aurora, Suite B, Des Moines, IA 50322-5032 | 2018-09-11 |
| 1588147979 | William Spencer | Counselor | 1063 14th Pl # A, Des Moines, IA 50314-1245 | 2018-09-11 |
| 1457830184 | Deborah L Devries | Counselor | 28313 Redondo Way S Apt 104, Des Moines, WA 98198-8256 | 2018-08-13 |
| 1699288498 | Vincent Kelly | Counselor | 4910 Urbandale Ave Ste 304, Des Moines, IA 50310-2661 | 2017-11-15 |
| 1851839864 | Lawrence Scanlon | Counselor | 412 42nd St, Des Moines, IA 50312 | 2017-02-09 |
| Find all providers in DES MOINES | ||||
| City | DES MOINES |
| Zip Code | 50312 |
Please comment or provide details below to improve the information on LARISSA BUSTAMANTE.
| 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.