Provider Demographics
NPI:1295011443
Name:HARPER, ELYSE ROSE (MFCS, LMFT)
Entity type:Individual
Prefix:
First Name:ELYSE
Middle Name:ROSE
Last Name:HARPER
Suffix:
Gender:F
Credentials:MFCS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14225 UNIVERSITY AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-8294
Mailing Address - Country:US
Mailing Address - Phone:712-592-7915
Mailing Address - Fax:
Practice Address - Street 1:14225 UNIVERSITY AVE STE 118
Practice Address - Street 2:
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-8294
Practice Address - Country:US
Practice Address - Phone:712-592-7915
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000352106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist