Provider Demographics
NPI:1578301248
Name:COUNSELING ASSOCIATES OF NE IOWA
Entity type:Organization
Organization Name:COUNSELING ASSOCIATES OF NE IOWA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BREVIG
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:563-419-4024
Mailing Address - Street 1:310 DAY ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2217
Mailing Address - Country:US
Mailing Address - Phone:563-419-4024
Mailing Address - Fax:
Practice Address - Street 1:806 COMMERCE DR STE A
Practice Address - Street 2:
Practice Address - City:DECORAH
Practice Address - State:IA
Practice Address - Zip Code:52101-2363
Practice Address - Country:US
Practice Address - Phone:563-387-8028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty