PRO CARE MENTAL HEALTH INC (NPI# 1356885024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356885024 |
| Entity Type | Organization |
| Organization Name | PRO CARE MENTAL HEALTH INC |
| Practice Address |
421 S 243rd St Waterloo NE 68069-4704 |
| Practice Telephone | 4029801697 |
| Practice Fax Number | 4028963695 |
| Mailing Telephone | 4029801697 |
| Mailing Fax Number | 4028963695 |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2016-12-14 |
| Authorized Official Name | DEAN A LIST (OWNER) |
| Authorized Official Telephone | 4029801697 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
110412 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
421 S 243RD ST |
| City | WATERLOO |
| State | NE |
| Zip Code | 68069-4704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265596183 | Waterloo Fire Department | Ambulance | 4th & North Front St, Waterloo, NE 68069 | 2006-12-22 |
| 1265649131 | Cynthia S Meier | Counselor | 201 3rd Street, Waterloo, NE 68069-0279 | 2007-05-17 |
| 1003420100 | Paige Stanzel | Physician Assistant | 610 Jefferson St, Waterloo, NE 68069-2212 | 2020-09-04 |
| 1194042788 | Waterloo Fire and Rescue | Ambulance | 405 7th St, Waterloo, NE 68069-2245 | 2010-04-23 |
| 1649804451 | Carnahan Pediatric Therapy, LLC | Physical Therapist | 800 N Front St Ste 510, Waterloo, NE 68069-2249 | 2020-03-02 |
| 1245361260 | Carl F Dorner IIi | Counselor | 23506 F St # 5, Waterloo, NE 68069-4209 | 2007-03-08 |
| 1568076594 | Michelle Ann Tsatsos | Speech-Language Pathologist | 24918 Mason St, Waterloo, NE 68069-4434 | 2020-09-08 |
| 1134408321 | Kristin Jean Korth | Occupational Therapist | 134 N 248th Cir, Waterloo, NE 68069-4690 | 2011-08-05 |
| 1770838997 | Lezli Mantzaris | Counselor | 1314 S 258th St, Waterloo, NE 68069-4814 | 2012-07-14 |
| 1285940791 | Richard M Buttner Dpt PC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 24325 Howard Cir, Waterloo, NE 68069-4839 | 2010-08-20 |
| Find all providers in zip 68069 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962025767 | Abby Staudt | Nurse Practitioner | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2020-05-27 |
| 1700366101 | Kelly Scheffert | Nurse Practitioner | 1825 Logan Ave, Waterloo, IA 50703-1916 | 2018-08-16 |
| 1255823506 | Nicole Delagardelle | Nurse Practitioner | 3251 W 9th St, Waterloo, IA 50702 | 2018-06-02 |
| 1962999672 | Merve Akova | Nurse Practitioner | 146 W Dale St Ste 101, Waterloo, IA 50703-1901 | 2018-04-18 |
| 1932652757 | Kelsie Swisher | Nurse Practitioner | 3251 W 9th St, Waterloo, IA 50702-5310 | 2016-07-28 |
| 1003216839 | Evans Komen | Nurse Practitioner | 2750 Saint Francis Dr, Waterloo, IA 50702-5644 | 2014-08-29 |
| 1154637692 | Joellen Cizek Kubik | Nurse Practitioner | 146 W Dale St, Suite 101, Waterloo, IA 50703-1901 | 2010-08-22 |
| 1598907545 | Michele D Moldrem | Nurse Practitioner | 988 N Illinois Route 3, Waterloo, IL 62298 | 2009-04-06 |
| 1013115757 | Dianna Kay Magginetti | Nurse Practitioner | 905 Franklin St, Waterloo, IA 50703-4407 | 2007-07-03 |
| 1023178548 | Dieter J Boxmann | Nurse Practitioner | 146 W Dale St, Suite 101, Waterloo, IA 50703-1901 | 2006-12-12 |
| Find all providers in WATERLOO | ||||
Please comment or provide details below to improve the information on PRO CARE MENTAL HEALTH 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.