| Crosswalk Counseling Center Llc | |
|
2550 Middle Road Suite 300 Bettendorf IA 52722-3287 | |
| (319) 230-8018 | |
| (563) 445-2308 |
| Full Name | Crosswalk Counseling Center Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2550 Middle Road, Bettendorf, Iowa |
| Authorized Official Name and Position | Lori Ann Pedersen (SOLE PROPRIETOR) |
| Authorized Official Contact | 3192308018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Crosswalk Counseling Center Llc 2550 Middle Road Suite 300 Bettendorf IA 52722-3287 Ph: (319) 230-8018 | Crosswalk Counseling Center Llc 2550 Middle Road Suite 300 Bettendorf IA 52722-3287 Ph: (319) 230-8018 |
| NPI Number | 1295105039 |
|---|---|
| Provider Enumeration Date | 10/06/2015 |
| Last Update Date | 10/06/2015 |
| Medicare PECOS PAC ID | 4688983109 |
|---|---|
| Medicare Enrollment ID | O20151023002298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295105039 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007084 (Iowa) | Primary |
| Provider Name | Lori A Pedersen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518122670 PECOS PAC ID: 9133276538 Enrollment ID: I20140514000862 |
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