| Kivisto Counseling And Therapy Llc | |
|
2550 Middle Rd Ste 3 Bettendorf IA 52722-3298 | |
| (563) 265-0825 | |
| Not Available |
| Full Name | Kivisto Counseling And Therapy Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2550 Middle Rd Ste 3, Bettendorf, Iowa |
| Authorized Official Name and Position | Sarah Rachel Kivisto (PRESIDENT) |
| Authorized Official Contact | 5632650825 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kivisto Counseling And Therapy Llc 24666 257th St Princeton IA 52768-9727 Ph: (563) 265-0825 | Kivisto Counseling And Therapy Llc 2550 Middle Rd Ste 3 Bettendorf IA 52722-3298 Ph: (563) 265-0825 |
| NPI Number | 1659991610 |
|---|---|
| Provider Enumeration Date | 04/20/2020 |
| Last Update Date | 04/20/2020 |
| Certification Date | 04/20/2020 |
| Medicare PECOS PAC ID | 9234560186 |
|---|---|
| Medicare Enrollment ID | O20200511000945 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659991610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sarah R Kivisto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1568675361 PECOS PAC ID: 3173693579 Enrollment ID: I20080528000088 |
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