Provider Demographics
NPI:1477237931
Name:THE CENTER FOR SELF LLC
Entity Type:Organization
Organization Name:THE CENTER FOR SELF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:BLADER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW
Authorized Official - Phone:319-435-1677
Mailing Address - Street 1:2135 LINCOLNSHIRE DR SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-1656
Mailing Address - Country:US
Mailing Address - Phone:319-435-1677
Mailing Address - Fax:319-409-8275
Practice Address - Street 1:4403 1ST AVE SE STE 310
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3221
Practice Address - Country:US
Practice Address - Phone:319-435-1677
Practice Address - Fax:319-409-8275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty