Provider Demographics
NPI:1477179133
Name:NEUBAUER, JAMES L (T-LMFT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:NEUBAUER
Suffix:
Gender:M
Credentials:T-LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 CENTER POINT RD NE STE A
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-2926
Mailing Address - Country:US
Mailing Address - Phone:319-382-8660
Mailing Address - Fax:319-382-8693
Practice Address - Street 1:3745 CENTER POINT RD NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-2926
Practice Address - Country:US
Practice Address - Phone:319-382-8660
Practice Address - Fax:319-382-8693
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA100484101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health