| Cross Therapy Center Pllc | |
|
20 Frank St Council Bluffs IA 51503-4460 | |
| (712) 256-9000 | |
| (712) 256-7710 |
| Full Name | Cross Therapy Center Pllc |
|---|---|
| Speciality | Counselor |
| Location | 20 Frank St, Council Bluffs, Iowa |
| Authorized Official Name and Position | Kate Cross (OWNER) |
| Authorized Official Contact | 4026500900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cross Therapy Center Pllc 20 Frank St Council Bluffs IA 51503-4460 Ph: (712) 256-9000 | Cross Therapy Center Pllc 20 Frank St Council Bluffs IA 51503-4460 Ph: (712) 256-9000 |
| NPI Number | 1114425592 |
|---|---|
| Provider Enumeration Date | 01/31/2018 |
| Last Update Date | 01/31/2018 |
| Medicare PECOS PAC ID | 8022342708 |
|---|---|
| Medicare Enrollment ID | O20190701000094 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114425592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Tonyarae C Bouvier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699018382 PECOS PAC ID: 4385978063 Enrollment ID: I20190701000124 |
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