NORTHEAST IOWA MENTAL HEALTH CENTER (NPI# 1710933445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710933445 |
| Entity Type | Organization |
| Organization Name | NORTHEAST IOWA MENTAL HEALTH CENTER |
| Other Organization Name | NORTHEAST IOWA BEHAVIORAL HEALTH, INC. |
| Practice Address |
905 Montgomery St Decorah IA 52101-2325 |
| Mailing Address |
Po Box 349 905 Montgomery St. Decorah IA 52101-0349 |
| Practice Telephone | 5633823649 |
| Practice Fax Number | 5633828183 |
| Mailing Telephone | 5633823649 |
| Mailing Fax Number | 5633828183 |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2012-04-18 |
| Authorized Official Name | MRS. MARCIA OLTROGGE (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5633823649 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
NONE | IA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | 0074559 | 05 |
| Other Name | Type Code |
|---|---|
| Northeast Iowa Behavioral Health, Inc. | Doing Business As Name - Organization |
| Street Address |
905 MONTGOMERY ST |
| City | DECORAH |
| State | IA |
| Zip Code | 52101-2325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083225130 | Megan Andera | Social Worker | 905 Montgomery St, Decorah, IA 52101-2325 | 2020-08-12 |
| 1659938165 | Nicole Brevig | Counselor | 905 Montgomery St, Decorah, IA 52101-2325 | 2019-05-21 |
| 1376109132 | Adam Elwood | Counselor | 905 Montgomery St, Decorah, IA 52101-2325 | 2019-05-16 |
| 1164980462 | Erin Anderson | Social Worker | 905 Montgomery St, Decorah, IA 52101-2325 | 2019-03-05 |
| 1962947663 | Angela Gibbs | Registered Nurse | 905 Montgomery St, Decorah, IA 52101-2325 | 2017-01-04 |
| 1164964128 | David Eldridge | Registered Nurse | 905 Montgomery St, Decorah, IA 52101-2325 | 2016-11-08 |
| 1891144119 | Trevor Dismore | Social Worker | 905 Montgomery St, Decorah, IA 52101-2325 | 2016-06-07 |
| 1083079438 | Kathryn Sieck | Social Worker | 905 Montgomery St, Decorah, IA 52101-2325 | 2015-12-29 |
| 1205206018 | Roberta Oloughlin | Registered Nurse | 905 Montgomery St, Decorah, IA 52101-2325 | 2015-10-06 |
| 1568867935 | Mary Oyloe | Registered Nurse | 905 Montgomery St, Decorah, IA 52101-2325 | 2014-10-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757911 | Andrew W Fritz | Specialist/Technologist | 700 College Drive, Regents Center, Decorah, IA 52101 | 2019-02-26 |
| 1265846935 | Amber Lynn Mccarville | Dentist | 501 Sanford, Decorah, IA 52101 | 2014-06-20 |
| 1669893988 | Winneshiek Medical Center | Clinic/Center | 112 East Main St., Ossian, IA 52101 | 2014-01-06 |
| 1467589317 | Brenda Harris | Acupuncturist | 309 West Broadway Street, Decorah, IA 52101 | 2007-02-27 |
| 1487721809 | Mary Christine Atkinson | Counselor | 1111 Paine Street, Decorah, IA 52101 | 2006-11-29 |
| 1578632220 | Kirsten Ann Ludwig | Counselor | 1111 Paine St, Decorah, IA 52101 | 2006-11-07 |
| 1760585350 | Dental Associates of Decorah PC | Dentist | 501 Sanford St, Decorah, IA 52101 | 2006-09-07 |
| 1780634196 | Theresa K Fullhart | Social Worker | 905 Montgomery Street, Decorah, IA 52101 | 2006-05-10 |
| 1487620688 | Mayo Clinic Hospital-rochester | Clinic/Center | 901 Montgomery Street, Decorah, IA 52101 | 2006-02-27 |
| 1205298668 | Benjamin Avi Levinson | Nurse Anesthetist, Certified Registered | 901 Montgomery St, Decorah, IA 52101 | 2016-03-24 |
| Find all providers in zip 52101 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1124626320 | Restoration Behavioral Health Center, Inc. | Clinic/Center | 1235 Sampson Street, Des Moines, IA 50316 | 2020-10-12 |
| 1285243337 | Ames Creative Healing Counseling | Clinic/Center | 2135 N Dakota Ave, Ames, IA 50014-9016 | 2020-07-24 |
| 1487289252 | Compass Counseling Services, LLC | Clinic/Center | 305 Tara Way, Lawton, IA 51030-1026 | 2020-03-11 |
| 1457986457 | Compassionate Counseling LLC | Clinic/Center | 402 N B St Ste 104, Fairfield, IA 52556-2971 | 2020-03-10 |
| 1053945576 | North Central Iowa Mental Health Center Inc | Clinic/Center | 2633 Anchorage Rd Ne, Solon, IA 52333-9556 | 2020-02-24 |
| 1811533649 | Community Health Centers of Southern Iowa, Inc. | Clinic/Center | 219 W Washington St Ste 300, Osceola, IA 50213-1249 | 2019-11-27 |
| 1568007805 | Community Health Centers of Southern Iowa, Inc. | Clinic/Center | 219 W Washington St Ste 200, Osceola, IA 50213-1249 | 2019-11-11 |
| 1548805021 | Central Iowa Trauma and Recovery Center | Clinic/Center | 301 E Court Ave Ste 105, Des Moines, IA 50309-2004 | 2019-11-08 |
| 1750938825 | Paradocs Psychological Services | Clinic/Center | 1400 Walnut St #110, Onyx Business, Des Moines, IA 50309 | 2019-08-22 |
| Find all providers with the same taxonomy | ||||
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| 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.