| Life Connection, L.c. | |
|
1953 1st Ave Se Cedar Rapids IA 52402-5328 | |
| (319) 364-1953 | |
| (319) 364-1970 |
| Full Name | Life Connection, L.c. |
|---|---|
| Speciality | Early Intervention Provider Agency |
| Location | 1953 1st Ave Se, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Benjamin D. Eilers (MANAGING PARTNER) |
| Authorized Official Contact | 5157206367 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Connection, L.c. 1953 1st Ave Se Cedar Rapids IA 52402-5328 Ph: (319) 364-1953 | Life Connection, L.c. 1953 1st Ave Se Cedar Rapids IA 52402-5328 Ph: (319) 364-1953 |
| NPI Number | 1538300892 |
|---|---|
| Provider Enumeration Date | 03/17/2009 |
| Last Update Date | 06/02/2022 |
| Certification Date | 06/02/2022 |
| Medicare PECOS PAC ID | 2567881428 |
|---|---|
| Medicare Enrollment ID | O20200928001298 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538300892 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | 06248 (Iowa) | Secondary |
| 252Y00000X | Early Intervention Provider Agency | (* (Not Available)) | Primary |
| Provider Name | Erin Colleen Aude |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336693399 PECOS PAC ID: 0547689408 Enrollment ID: I20240120000389 |
| Provider Name | Alyssa Christine Hennings |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285185736 PECOS PAC ID: 5193144053 Enrollment ID: I20240122002772 |
| Provider Name | Brandi Leigh Sohn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093327264 PECOS PAC ID: 7517319924 Enrollment ID: I20240122003438 |
| Provider Name | Morgan Elizabeth Dewitt |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639770001 PECOS PAC ID: 0345693347 Enrollment ID: I20240125003635 |
| Provider Name | Courtney Paige Hickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245823913 PECOS PAC ID: 4587017132 Enrollment ID: I20240130003074 |
| Provider Name | Meryl Rae Welsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1689904690 PECOS PAC ID: 8325481484 Enrollment ID: I20240206003424 |
| Provider Name | Ashlyn Elizabeth Wernimont |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942946983 PECOS PAC ID: 1254774813 Enrollment ID: I20240210000346 |
| Provider Name | Dawn Marie Doerr-johnson |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1780128173 PECOS PAC ID: 2163867722 Enrollment ID: I20240305002865 |
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