| Casey Theis Counseling, Llc | |
|
810 Locust St Dubuque IA 52001-6705 | |
| (563) 275-6763 | |
| (563) 217-4013 |
| Full Name | Casey Theis Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 810 Locust St, Dubuque, Iowa |
| Authorized Official Name and Position | Casey Edwards (OWNER/THERAPIST) |
| Authorized Official Contact | 5634512489 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Casey Theis Counseling, Llc 810 Locust St Dubuque IA 52001-6705 Ph: (563) 275-6763 | Casey Theis Counseling, Llc 810 Locust St Dubuque IA 52001-6705 Ph: (563) 275-6763 |
| NPI Number | 1932612918 |
|---|---|
| Provider Enumeration Date | 11/13/2017 |
| Last Update Date | 11/13/2017 |
| Medicare PECOS PAC ID | 5193084572 |
|---|---|
| Medicare Enrollment ID | O20180110000557 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932612918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 072407 (Iowa) | Primary |
| Provider Name | Casey L Edwards |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629480355 PECOS PAC ID: 0446519540 Enrollment ID: I20180118000803 |
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