=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831040187
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PEYTON EMGARTEN CADC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2026
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 405 E 5TH ST
-----------------------------------------------------
City | WATERLOO
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50703-5705
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-370-0719
-----------------------------------------------------
Fax | 515-220-2272
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 907 W 7TH ST STE 202
-----------------------------------------------------
City | CEDAR FALLS
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50613-2433
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 515-220-2272
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number | 25021
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------