| Elevating Awareness Therapy Services, Llc | |
|
3641 Kimball Ave Ste 207 Waterloo IA 50702-5757 | |
| (319) 318-0178 | |
| (319) 320-1121 |
| Full Name | Elevating Awareness Therapy Services, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3641 Kimball Ave Ste 207, Waterloo, Iowa |
| Authorized Official Name and Position | Nichole Clarke (OWNER/LMFT) |
| Authorized Official Contact | 3196215300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevating Awareness Therapy Services, Llc 3641 Kimball Ave Ste 207 Waterloo IA 50702-5757 Ph: (319) 318-0178 | Elevating Awareness Therapy Services, Llc 3641 Kimball Ave Ste 207 Waterloo IA 50702-5757 Ph: (319) 318-0178 |
| NPI Number | 1629789854 |
|---|---|
| Provider Enumeration Date | 12/08/2022 |
| Last Update Date | 12/08/2022 |
| Certification Date | 12/08/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629789854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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