Angie Kay Dewaard, LPC | |
320 N Eisenhower Ave, Mason City, IA 50401-1521 | |
(641) 424-2391 | |
(641) 424-0783 |
Full Name | Angie Kay Dewaard |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 320 N Eisenhower Ave, Mason City, Iowa |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1164763413 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 001615 (Iowa) | Secondary |
101YP2500X | Counselor - Professional | 81764 (Texas) | Primary |
Entity Name | Sondermind Provider Network Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760854442 PECOS PAC ID: 9537572490 Enrollment ID: O20210326001541 |
Mailing Address | Practice Location Address |
---|---|
Angie Kay Dewaard, LPC 218 E Bridge St Apt 12, Granbury, TX 76048-2234 Ph: (641) 780-2741 | Angie Kay Dewaard, LPC 320 N Eisenhower Ave, Mason City, IA 50401-1521 Ph: (641) 424-2391 |
Courtney Cockrum, Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 N Eisenhower Ave, Mason City, IA 50401 Phone: 641-243-7257 | |
Melody Lynn Stone, MA LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 516 N Jefferson Ave, Mason City, IA 50401 Phone: 641-424-8344 | |
Jennifer Lynn Gehrls, T-CADC Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 N Eisenhower Ave, Mason City, IA 50401 Phone: 641-424-2391 | |
Bridget Powers Grady, LMFT Counselor Medicare: Not Enrolled in Medicare Practice Location: 520 S Pierce Ave Ste 213, Mason City, IA 50401 Phone: 641-426-0650 | |
Leah Jean Weber, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 22 N Georgia Ave, Suite 102, Mason City, IA 50401 Phone: 641-422-0070 Fax: 641-422-0060 | |
Stephen Daniel Blackman, B.A. Counselor Medicare: Not Enrolled in Medicare Practice Location: 320 N Eisenhower Ave, Mason City, IA 50401 Phone: 641-243-7235 | |
Ms. Lisa A Worden, Counselor Medicare: Not Enrolled in Medicare Practice Location: 687 S Taft Ave, Mason City, IA 50401 Phone: 641-210-7708 |