Provider Demographics
NPI:1164131504
Name:BELLALUNA BEHAVIORAL HEALTH, PLLC
Entity Type:Organization
Organization Name:BELLALUNA BEHAVIORAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LENSING
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:641-330-7671
Mailing Address - Street 1:2305 VALLEY HIGH DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6162
Mailing Address - Country:US
Mailing Address - Phone:641-330-7671
Mailing Address - Fax:
Practice Address - Street 1:3120 KIMBALL AVE STE C
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5272
Practice Address - Country:US
Practice Address - Phone:641-330-7671
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-15
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty