| Blue Tree Counseling & Consultation | |
|
3475 Jersey Ridge Rd Ste 2 Davenport IA 52807-2293 | |
| (319) 481-3534 | |
| (563) 213-5615 |
| Full Name | Blue Tree Counseling & Consultation |
|---|---|
| Speciality | Social Worker |
| Location | 3475 Jersey Ridge Rd Ste 2, Davenport, Iowa |
| Authorized Official Name and Position | Jillyn M Kaufman (OWNER/CLINICAL THERAPIST) |
| Authorized Official Contact | 3194813534 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Tree Counseling & Consultation 3475 Jersey Ridge Rd Ste 2 Davenport IA 52807-2293 Ph: (319) 481-3534 | Blue Tree Counseling & Consultation 3475 Jersey Ridge Rd Ste 2 Davenport IA 52807-2293 Ph: (319) 481-3534 |
| NPI Number | 1760095582 |
|---|---|
| Provider Enumeration Date | 08/31/2020 |
| Last Update Date | 12/10/2022 |
| Certification Date | 12/10/2022 |
| Medicare PECOS PAC ID | 5698193456 |
|---|---|
| Medicare Enrollment ID | O20200911000411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760095582 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jillyn M Kaufman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528225158 PECOS PAC ID: 9537315163 Enrollment ID: I20120814000042 |
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