| Robyn Rodenburgh, Inc. | |
|
142 Brookeridge Dr Waterloo IA 50702-5702 | |
| (319) 231-5871 | |
| (888) 981-5029 |
| Full Name | Robyn Rodenburgh, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 142 Brookeridge Dr, Waterloo, Iowa |
| Authorized Official Name and Position | Robyn Rodenburgh (OWNER) |
| Authorized Official Contact | 3192315871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Robyn Rodenburgh, Inc. 104 Brookeridge Dr # 186 Waterloo IA 50702-5702 Ph: (319) 231-5871 | Robyn Rodenburgh, Inc. 142 Brookeridge Dr Waterloo IA 50702-5702 Ph: (319) 231-5871 |
| NPI Number | 1225882731 |
|---|---|
| Provider Enumeration Date | 04/12/2024 |
| Last Update Date | 05/31/2024 |
| Certification Date | 05/30/2024 |
| Medicare PECOS PAC ID | 6002258761 |
|---|---|
| Medicare Enrollment ID | O20240525000130 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225882731 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Robyn L Rodenburgh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437395688 PECOS PAC ID: 0244672533 Enrollment ID: I20240531003623 |
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