| The Beverly Center For Trauma Therapy, Pllc | |
|
7405 University Ave Ste 10 Clive IA 50325-1343 | |
| (515) 650-6844 | |
| Not Available |
| Full Name | The Beverly Center For Trauma Therapy, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 7405 University Ave Ste 10, Clive, Iowa |
| Authorized Official Name and Position | Emberly Joe Lashley (LICENSED MENTAL HEALTH COUNSELOR) |
| Authorized Official Contact | 4802324076 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Beverly Center For Trauma Therapy, Pllc 155 Glendale Dr Waukee IA 50263-8534 Ph: (480) 232-4076 | The Beverly Center For Trauma Therapy, Pllc 7405 University Ave Ste 10 Clive IA 50325-1343 Ph: (515) 650-6844 |
| NPI Number | 1881282952 |
|---|---|
| Provider Enumeration Date | 01/05/2021 |
| Last Update Date | 04/23/2024 |
| Certification Date | 04/23/2024 |
| Medicare PECOS PAC ID | 3870935422 |
|---|---|
| Medicare Enrollment ID | O20240528002402 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881282952 | NPI | - | NPPES |
| Provider Name | Emberly Joe Lashley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1003308115 PECOS PAC ID: 7911367560 Enrollment ID: I20240528002513 |
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