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EMERALD BRIDGES FAMILY THERAPY, LLC
NPI 1073966123
Social Worker - Clinical in Independence, IA

Active since July 13, 2016
2349 JAMESTOWN AVE, SUITE 5, INDEPENDENCE, IA 50644(563) 579-1181(319) 332-1241 Get Directions Write a Review

NPPES record last updated: July 13, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Emerald Bridges Family Therapy, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMERALD BRIDGES FAMILY THERAPY, LLC (NPI 1073966123) is a healthcare organization registered as a clinical in Independence, Iowa and active in the NPI registry since July 2016. The organization lists Tara Nissen, Mental Health Therapist, as its authorized official.

NPPES Registry Identity

NPI1073966123
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameEMERALD BRIDGES FAMILY THERAPY, LLC
Location Address2349 JAMESTOWN AVE, SUITE 5Independence, IA 50644-9709
Mailing Address914 Oregon StWaterloo, IA 50702-2509 · (563) 579-1181
Phone(563) 579-1181
Fax(319) 332-1241
Organization SubpartNo
Authorized OfficialTara NissenMental Health Therapist · (563) 579-1181
Enumeration DateJuly 13, 2016
✔ NPI 1073966123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in IA · 007613
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
2349 JAMESTOWN AVE, Independence, IA 50644
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Emerald Bridges Family Therapy, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Emerald Bridges Family Therapy, LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Tara Bosnic, LISW
Clinical Social Worker
NPI 1417258351
2300 SWAN LAKE BLVD STE 102
Independence, IA 50644
(563) 579-1181
✔ PECOS✔ Accepts Medicare1.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emerald Bridges Family Therapy, LLC's NPI number?

The NPI number for Emerald Bridges Family Therapy, LLC is 1073966123. It was assigned to this organization in the NPPES registry on July 13, 2016.

Where is Emerald Bridges Family Therapy, LLC located?

Emerald Bridges Family Therapy, LLC is located at 2349 Jamestown Ave Suite 5, Independence, IA 50644. The listed phone number is (563) 579-1181.

What is Emerald Bridges Family Therapy, LLC's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Emerald Bridges Family Therapy, LLC enrolled in Medicare?

Yes. Emerald Bridges Family Therapy, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Emerald Bridges Family Therapy, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Social Worker) reassigns their Medicare billing to Emerald Bridges Family Therapy, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Emerald Bridges Family Therapy, LLC was last updated on July 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.