| J.a. Leverett, Llc | |
|
14679 230th St Council Bluffs IA 51503-7223 | |
| (712) 314-3326 | |
| Not Available |
| Full Name | J.a. Leverett, Llc |
|---|---|
| Speciality | Counselor |
| Location | 14679 230th St, Council Bluffs, Iowa |
| Authorized Official Name and Position | Jennifer A Leverett (OWNER MENTAL HEALTH THERAPIST) |
| Authorized Official Contact | 7123143326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| J.a. Leverett, Llc 2750 5th Ave Council Bluffs IA 51501-3546 Ph: (712) 314-3326 | J.a. Leverett, Llc 14679 230th St Council Bluffs IA 51503-7223 Ph: (712) 314-3326 |
| NPI Number | 1891525515 |
|---|---|
| Provider Enumeration Date | 08/06/2024 |
| Last Update Date | 09/03/2024 |
| Certification Date | 09/03/2024 |
| Medicare PECOS PAC ID | 7113452913 |
|---|---|
| Medicare Enrollment ID | O20241202003401 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891525515 | NPI | - | NPPES |
| 5707373 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Jennifer A Leverett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184772402 PECOS PAC ID: 8022543826 Enrollment ID: I20241202003425 |
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