Provider Demographics
NPI:1922388990
Name:QUAD CITIES COUNSELING, PLLC
Entity Type:Organization
Organization Name:QUAD CITIES COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:ADEN
Authorized Official - Suffix:
Authorized Official - Credentials:LTSW
Authorized Official - Phone:563-484-0770
Mailing Address - Street 1:2550 MIDDLE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7905
Mailing Address - Country:US
Mailing Address - Phone:563-484-0770
Mailing Address - Fax:563-345-6245
Practice Address - Street 1:2550 MIDDLE ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:BETTENDORT
Practice Address - State:IA
Practice Address - Zip Code:52722
Practice Address - Country:US
Practice Address - Phone:563-484-0770
Practice Address - Fax:563-345-6245
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-23
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA059871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
L97195Medicare UPIN