| Your Self-care Therapy L.l.c. | |
|
300 W Broadway Ste 240 Council Bluffs IA 51503-9028 | |
| (402) 882-0583 | |
| (712) 254-8829 |
| Full Name | Your Self-care Therapy L.l.c. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 300 W Broadway Ste 240, Council Bluffs, Iowa |
| Authorized Official Name and Position | Kelly Deroos (PRESIDENT) |
| Authorized Official Contact | 4028820583 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Self-care Therapy L.l.c. Po Box 780 Council Bluffs IA 51502-0780 Ph: (402) 882-0583 | Your Self-care Therapy L.l.c. 300 W Broadway Ste 240 Council Bluffs IA 51503-9028 Ph: (402) 882-0583 |
| NPI Number | 1790314243 |
|---|---|
| Provider Enumeration Date | 04/06/2020 |
| Last Update Date | 03/15/2024 |
| Certification Date | 03/15/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790314243 | NPI | - | NPPES |
| 0707101 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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