| Revolution Counseling Services Llc | |
|
601 Brady St Ste 204 Davenport IA 52803-5251 | |
| (309) 781-4053 | |
| (309) 792-2440 |
| Full Name | Revolution Counseling Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 601 Brady St Ste 204, Davenport, Iowa |
| Authorized Official Name and Position | Kari Lee Stearns-lamb (OWNER/PROVIDER) |
| Authorized Official Contact | 3097814053 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Revolution Counseling Services Llc 601 Brady St Ste 204 Davenport IA 52803-5251 Ph: (309) 781-4053 | Revolution Counseling Services Llc 601 Brady St Ste 204 Davenport IA 52803-5251 Ph: (309) 781-4053 |
| NPI Number | 1093201444 |
|---|---|
| Provider Enumeration Date | 07/09/2018 |
| Last Update Date | 07/09/2018 |
| Medicare PECOS PAC ID | 9133466915 |
|---|---|
| Medicare Enrollment ID | O20190201000634 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093201444 | NPI | - | NPPES |
| 1831565290 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 078821 (Iowa) | Primary |
| 1041C0700X | Social Worker - Clinical | 149019131 (Illinois) | Secondary |
| Provider Name | Kari L Stearns-lamb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831565290 PECOS PAC ID: 4587941737 Enrollment ID: I20170426000860 |
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