| Eastern Iowa Family Counseling | |
|
204 Glenn St Se Ste 2 Mount Vernon IA 52314-1501 | |
| (319) 777-1092 | |
| (319) 449-3585 |
| Full Name | Eastern Iowa Family Counseling |
|---|---|
| Speciality | Social Worker |
| Location | 204 Glenn St Se Ste 2, Mount Vernon, Iowa |
| Authorized Official Name and Position | Julianna Gondek (OWNER/LISW) |
| Authorized Official Contact | 3197771092 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eastern Iowa Family Counseling 204 Glenn St Se Ste 2 Mount Vernon IA 52314-1501 Ph: (319) 777-1092 | Eastern Iowa Family Counseling 204 Glenn St Se Ste 2 Mount Vernon IA 52314-1501 Ph: (319) 777-1092 |
| NPI Number | 1558899179 |
|---|---|
| Provider Enumeration Date | 05/26/2017 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 0547527467 |
|---|---|
| Medicare Enrollment ID | O20171201001232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558899179 | NPI | - | NPPES |
| 0113927 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007320 (Iowa) | Primary |
| Provider Name | Julianna Marie Gondek |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548528672 PECOS PAC ID: 1254698178 Enrollment ID: I20171201001399 |
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