| The Lodge Counseling & Consuliting | |
|
705 Douglas St Suite # 208 Sioux City IA 51101-1048 | |
| (712) 259-5134 | |
| Not Available |
| Full Name | The Lodge Counseling & Consuliting |
|---|---|
| Speciality | Counselor |
| Location | 705 Douglas St, Sioux City, Iowa |
| Authorized Official Name and Position | Vincent Mahon (CO-OWNER) |
| Authorized Official Contact | 7122595134 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| The Lodge Counseling & Consuliting 705 Douglas St Suite # 208 Sioux City IA 51101-1048 Ph: (712) 259-5134 | The Lodge Counseling & Consuliting 705 Douglas St Suite # 208 Sioux City IA 51101-1048 Ph: (712) 259-5134 |
| NPI Number | 1629359872 |
|---|---|
| Provider Enumeration Date | 09/01/2011 |
| Last Update Date | 09/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629359872 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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