| Wapsi Valley Family Counseling, Llc | |
|
2300 Swan Lake Rd Ste 102 Independence IA 50644-9708 | |
| (319) 361-4867 | |
| (319) 332-1241 |
| Full Name | Wapsi Valley Family Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2300 Swan Lake Rd Ste 102, Independence, Iowa |
| Authorized Official Name and Position | Jacquelyn Kay Schultz (OWNER) |
| Authorized Official Contact | 3193614867 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wapsi Valley Family Counseling, Llc 2300 Swan Lake Blvd Ste 102 Independence IA 50644-9708 Ph: (319) 361-4867 | Wapsi Valley Family Counseling, Llc 2300 Swan Lake Rd Ste 102 Independence IA 50644-9708 Ph: (319) 361-4867 |
| NPI Number | 1194124297 |
|---|---|
| Provider Enumeration Date | 08/14/2014 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 0244458685 |
|---|---|
| Medicare Enrollment ID | O20140827001703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194124297 | NPI | - | NPPES |
| 600931888 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 04543 (Iowa) | Primary |
| Provider Name | Jacquelyn K Schultz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578876223 PECOS PAC ID: 0840315362 Enrollment ID: I20100921000245 |
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