Provider Demographics
NPI:1346750924
Name:ALLEN COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:ALLEN COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:515-207-0310
Mailing Address - Street 1:13375 UNIVERSITY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8260
Mailing Address - Country:US
Mailing Address - Phone:515-207-0310
Mailing Address - Fax:
Practice Address - Street 1:13375 UNIVERSITY AVE STE 201
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8260
Practice Address - Country:US
Practice Address - Phone:515-207-0310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001420225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA600845919Medicaid