Provider Demographics
NPI:1659970622
Name:PELLA COUNSELING PLC
Entity Type:Organization
Organization Name:PELLA COUNSELING PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAVERKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-545-6226
Mailing Address - Street 1:1535 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1048
Mailing Address - Country:US
Mailing Address - Phone:641-629-0391
Mailing Address - Fax:
Practice Address - Street 1:1535 TERRACE DR
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1048
Practice Address - Country:US
Practice Address - Phone:641-629-0391
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty