| Alli Center Llc | |
|
1150 5th St Ste 270 Coralville IA 52241-2933 | |
| (319) 804-9312 | |
| (319) 449-3845 |
| Full Name | Alli Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1150 5th St Ste 270, Coralville, Iowa |
| Authorized Official Name and Position | Zara Wanlass (CO-OWNER AND BUSINESS MANAGER) |
| Authorized Official Contact | 3198049312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alli Center Llc 1150 5th St Ste 270 Coralville IA 52241-2933 Ph: (319) 804-9312 | Alli Center Llc 1150 5th St Ste 270 Coralville IA 52241-2933 Ph: (319) 804-9312 |
| NPI Number | 1699286427 |
|---|---|
| Provider Enumeration Date | 10/19/2017 |
| Last Update Date | 10/29/2020 |
| Certification Date | 10/29/2020 |
| Medicare PECOS PAC ID | 9638439128 |
|---|---|
| Medicare Enrollment ID | O20180131002794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699286427 | NPI | - | NPPES |
| 0710977 | Medicaid | IA | |
| 1881993160 | Medicaid | IA |
| Provider Name | Bonnie E Seely |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871899013 PECOS PAC ID: 9739361395 Enrollment ID: I20110303000594 |
| Provider Name | Stacy A Davids |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891793758 PECOS PAC ID: 8325164700 Enrollment ID: I20130827000278 |
| Provider Name | Jason Knight |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881993160 PECOS PAC ID: 4880824036 Enrollment ID: I20140307001492 |
| Provider Name | Miranda Kelly Maday |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841590544 PECOS PAC ID: 5597026237 Enrollment ID: I20180221000599 |
| Provider Name | Kinsey Wohlers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275027633 PECOS PAC ID: 0446677835 Enrollment ID: I20200831002389 |
| Provider Name | Beth Marie Krayenhagen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851890099 PECOS PAC ID: 6507270998 Enrollment ID: I20210126002014 |
| Provider Name | Stephanie Lynn Van Housen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518555150 PECOS PAC ID: 7911315254 Enrollment ID: I20210426001720 |
| Provider Name | Michael D Markham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588298467 PECOS PAC ID: 5193124980 Enrollment ID: I20210527001619 |
| Provider Name | Lance Lashley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598438491 PECOS PAC ID: 1951706431 Enrollment ID: I20210820002693 |
| Provider Name | Daryl Byrd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003394016 PECOS PAC ID: 5991173080 Enrollment ID: I20221121002628 |
| Provider Name | Kirby Rowl |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679130967 PECOS PAC ID: 4880052513 Enrollment ID: I20230628000135 |
| Provider Name | Lori Holman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528429628 PECOS PAC ID: 1052672532 Enrollment ID: I20231221000675 |
| Provider Name | James Joseph Gomez |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1700538881 PECOS PAC ID: 7012367238 Enrollment ID: I20231229000582 |
| Provider Name | Rachel Huntington |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1386028637 PECOS PAC ID: 4183075161 Enrollment ID: I20240104001705 |
| Provider Name | Alexandria Solveig Mcnamee |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1497274138 PECOS PAC ID: 4587015490 Enrollment ID: I20240104003116 |
| Provider Name | Trisha Ann Maulson Dean |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1700300316 PECOS PAC ID: 6709238652 Enrollment ID: I20240117000942 |
| Provider Name | Kristine Taylor |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346808037 PECOS PAC ID: 1759724487 Enrollment ID: I20240229000248 |
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