| Counseling For Psychological Resilience | |
|
602 Otley Ave Perry IA 50220-1088 | |
| (515) 992-6638 | |
| Not Available |
| Full Name | Counseling For Psychological Resilience |
|---|---|
| Speciality | Social Worker |
| Location | 602 Otley Ave, Perry, Iowa |
| Authorized Official Name and Position | Stephanie Heitman (OWNER) |
| Authorized Official Contact | 5159926638 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling For Psychological Resilience Po Box 253 Perry IA 50220-0253 Ph: (515) 992-6638 | Counseling For Psychological Resilience 602 Otley Ave Perry IA 50220-1088 Ph: (515) 992-6638 |
| NPI Number | 1194463414 |
|---|---|
| Provider Enumeration Date | 05/25/2022 |
| Last Update Date | 05/16/2023 |
| Certification Date | 05/11/2023 |
| Medicare PECOS PAC ID | 2668839432 |
|---|---|
| Medicare Enrollment ID | O20230609000892 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194463414 | NPI | - | NPPES |
| 006958 | Medicaid | IA | |
| 107903 | Medicaid | IA | |
| 2218121 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie E Heitman-taggart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417212358 PECOS PAC ID: 1456667765 Enrollment ID: I20150901003022 |
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