WILLOW GROVE THERAPY GROUP LLC – Clinical Psychologist, NPI 1659873727
Clinical Psychologist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for WILLOW GROVE THERAPY GROUP LLC
9105 NORTHPARK DR
JOHNSTON, IA 501314807
Phone: (515) 984-0225
Fax: (515) 984-0226
Type: Location
205, 28th Street, Acadian Manor Apartments, Des Moines, Polk County, Iowa, 50312, United States
DES MOINES, IA 503124400
Phone: (515) 631-0454
Type: Mailing
5000 WESTOWN PKWY STE 100
WEST DES MOINES, IA 502665921
Phone: (515) 631-0454
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2018-06-04
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-02-29 (838 days ago).
Enrollment records
1
Earliest due date
2024-02-29
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20180604000282 | O | Clinic/Group Practice | IA | 2024-02-29 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 50131)
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