Healthcare Provider Details

I. General information

NPI: 1487070686
Provider Name (Legal Business Name): MATTHEW SCHMECKPEPER MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2014
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 FRANKLIN AVE
COUNCIL BLUFFS IA
51503-4515
US

IV. Provider business mailing address

542 FRANKLIN AVE
COUNCIL BLUFFS IA
51503-4515
US

V. Phone/Fax

Practice location:
  • Phone: 712-524-4093
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberP-2228
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10205
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number089650
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: