Provider Demographics
NPI:1932138088
Name:DACE, MARSHA (LMHC)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:DACE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 540
Mailing Address - Street 2:
Mailing Address - City:WEST BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52655-0540
Mailing Address - Country:US
Mailing Address - Phone:319-768-3450
Mailing Address - Fax:319-768-3460
Practice Address - Street 1:1225 S GEAR AVE
Practice Address - Street 2:STE 252
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1691
Practice Address - Country:US
Practice Address - Phone:319-768-3700
Practice Address - Fax:319-768-3712
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA00882OtherIOWA LICENSE