Provider Demographics
NPI:1497925382
Name:CEDAR FALLS COUNSELING ASSOCIATES
Entity Type:Organization
Organization Name:CEDAR FALLS COUNSELING ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:BERDENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEACH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:319-277-4383
Mailing Address - Street 1:324 W 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-2745
Mailing Address - Country:US
Mailing Address - Phone:319-277-4383
Mailing Address - Fax:319-268-2207
Practice Address - Street 1:324 W 3RD ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2745
Practice Address - Country:US
Practice Address - Phone:319-277-4383
Practice Address - Fax:319-268-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00012101YM0800X
IA00008106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty