Provider Demographics
NPI:1760113880
Name:WR FAMILY THERAPY, LLC
Entity Type:Organization
Organization Name:WR FAMILY THERAPY, LLC
Other - Org Name:SARAH KOSIBA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOSIBA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:712-401-7312
Mailing Address - Street 1:5402 MORNINGSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-3136
Mailing Address - Country:US
Mailing Address - Phone:712-401-7312
Mailing Address - Fax:319-271-6419
Practice Address - Street 1:5402 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-3136
Practice Address - Country:US
Practice Address - Phone:712-401-7312
Practice Address - Fax:319-271-6419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-20
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0223597Medicaid
NE10027029200Medicaid