Provider Demographics
NPI:1467142158
Name:HOWERTON CHILD AND FAMILY THERAPY LLC
Entity Type:Organization
Organization Name:HOWERTON CHILD AND FAMILY THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWERTON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:641-732-2021
Mailing Address - Street 1:13710 N 99TH AVE W
Mailing Address - Street 2:
Mailing Address - City:COLLINS
Mailing Address - State:IA
Mailing Address - Zip Code:50055-8529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13710 N 99TH AVE W
Practice Address - Street 2:
Practice Address - City:COLLINS
Practice Address - State:IA
Practice Address - Zip Code:50055-8529
Practice Address - Country:US
Practice Address - Phone:641-732-2021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1124528526Medicaid