Provider Demographics
NPI:1114202660
Name:QUAD-CITIES COUNSELING
Entity Type:Organization
Organization Name:QUAD-CITIES COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISW
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LISW
Authorized Official - Phone:563-484-0770
Mailing Address - Street 1:2550 MIDDLE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-3287
Mailing Address - Country:US
Mailing Address - Phone:563-484-0770
Mailing Address - Fax:888-662-3032
Practice Address - Street 1:2550 MIDDLE RD STE 300
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-3287
Practice Address - Country:US
Practice Address - Phone:563-484-0770
Practice Address - Fax:888-662-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-17
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA059871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1912917360OtherINDIVIDUAL NPI
IA1912917360OtherINDIVIDUAL NPI