NPI 1376850016 · live from the CMS NPI Registry
Grant Thomas Willms, M.Min.
Counselor, Mental Health in Council Bluffs, IA. National Provider Identifier 1376850016, active.
NPI record
| NPI | 1376850016 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Mental Health 101YM0800X |
| Practice location | 20 Frank St, Council Bluffs, IA 51503 |
| Practice phone | 712-323-4478 |
| Mailing address | 2132 S 42nd St, Omaha, NE 68105 |
| Enumerated | September 1, 2010 |
| Last updated | September 1, 2010 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor | 101Y00000X | 04986 (IA) |
| Counselor, Mental Health primary | 101YM0800X | 04986 (IA) |
| Counselor, Pastoral | 101YP1600X | 04986 (IA) |
| Counselor, Professional | 101YP2500X | 04986 (IA) |
| Social Worker, Clinical | 1041C0700X | 04986 (IA) |
| Marriage & Family Therapist | 106H00000X | 04986 (IA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.