| Angela Andeway, | |
|
110 E Main St, Ottumwa, IA 52501-2910 | |
| (641) 682-8772 | |
| (641) 682-1924 |
| Full Name | Angela Andeway |
|---|---|
| Gender | Female |
| Speciality | Counselor - Mental Health |
| Location | 110 E Main St, Ottumwa, Iowa |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215352059 | NPI | - | NPPES |
| 1659353670 | Other | IA | BLUE CROSS BLUE SHIELD |
| 1659353670 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | 072076 (Iowa) | Primary |
| Entity Name | Rodasi Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467691790 PECOS PAC ID: 0749418630 Enrollment ID: O20171101002494 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Andeway, 110 E Main St, Ottumwa, IA 52501-2910 Ph: (641) 682-8772 | Angela Andeway, 110 E Main St, Ottumwa, IA 52501-2910 Ph: (641) 682-8772 |
Mrs. Lori Lee Grim, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 W. Main St, Ottumwa, IA 52501 Phone: 641-683-6747 Fax: 641-683-6317 | |
Bekki Jane Klodt, LMHC, NCC Counselor Medicare: Not Enrolled in Medicare Practice Location: Po Box 1117, Ottumwa, IA 52501 Phone: 641-243-5952 | |
Ellie Jo Cloyed, TCADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1527 Albia Rd, Ottumwa, IA 52501 Phone: 641-814-8731 Fax: 641-682-1924 | |
Mrs. Suzette Kathryn Van Vark, LMHC, IADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 W. Main St, Ottumwa, IA 52501 Phone: 641-683-6747 Fax: 641-683-6317 | |
Mark Gillman, BA, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 W. Main St, Ottumwa, IA 52501 Phone: 641-683-6747 Fax: 641-683-6317 | |
Benjamin Lee Wyldes, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 310 W. Main St, Ottumwa, IA 52501 Phone: 641-683-6747 Fax: 641-683-6317 | |
Joshua Huffine, CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 102 N Hancock St, Ottumwa, IA 52501 Phone: 641-682-2800 Fax: 641-682-2826 |