MEDICARE: MICAH NICOLE DISBROW LMHC, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	105135	IA
2	101YP2500X	Professional Counselor	2013011886	MO

General Provider Information

NPI Number	:	1184061871
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAH NICOLE DISBROW LMHC, LPC

Provider Business Mailing Address
First Line	:	1509 PRAIRIE ROSE DR SW
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52404-8720
Country	:	US
Telephone Number	:	319-461-7177
Fax Number	:

Provider Business Practice Location Address
First Line	:	438 SOUTHGATE AVE
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-4425
Country	:	US
Telephone Number	:	319-351-4357
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/04/2013
Last Update Date	:	02/27/2026

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