| Center For Foundational & Relational Wellness Llc | |
|
2022 3rd Ave Nw Waverly IA 50677-2010 | |
| (319) 596-5910 | |
| Not Available |
| Full Name | Center For Foundational & Relational Wellness Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2022 3rd Ave Nw, Waverly, Iowa |
| Authorized Official Name and Position | Kathryn Haberman (CLINICAL DIRECTOR) |
| Authorized Official Contact | 3193461216 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Foundational & Relational Wellness Llc Po Box 2400 Waterloo IA 50704-2400 Ph: () - | Center For Foundational & Relational Wellness Llc 2022 3rd Ave Nw Waverly IA 50677-2010 Ph: (319) 596-5910 |
| NPI Number | 1588295695 |
|---|---|
| Provider Enumeration Date | 01/28/2020 |
| Last Update Date | 07/29/2020 |
| Certification Date | 07/29/2020 |
| Medicare PECOS PAC ID | 9739519505 |
|---|---|
| Medicare Enrollment ID | O20200417002447 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588295695 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Kathryn Haberman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831220094 PECOS PAC ID: 0042302739 Enrollment ID: I20070827000228 |
| Provider Name | Shelby Bennett |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336561430 PECOS PAC ID: 1456745611 Enrollment ID: I20220303002279 |
| Provider Name | Jennifer Renee Mccormick Rikkers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891404281 PECOS PAC ID: 1658749429 Enrollment ID: I20221129001211 |
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