| Lc Jr., Llc | |
|
1912 Middle Rd 300 B Bettendorf IA 52722-7600 | |
| (563) 275-6728 | |
| (563) 265-8088 |
| Full Name | Lc Jr., Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1912 Middle Rd, Bettendorf, Iowa |
| Authorized Official Name and Position | Jamie R Mcwade (OWNER) |
| Authorized Official Contact | 5632756728 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lc Jr., Llc 1912 Middle Rd 300 B Bettendorf IA 52722-7600 Ph: (563) 275-6728 | Lc Jr., Llc 1912 Middle Rd 300 B Bettendorf IA 52722-7600 Ph: (563) 275-6728 |
| NPI Number | 1720470362 |
|---|---|
| Provider Enumeration Date | 02/18/2015 |
| Last Update Date | 09/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720470362 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13040 (Iowa) | Secondary |
| 101YM0800X | Counselor - Mental Health | 001626 (Iowa) | Primary |
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