Provider Demographics
NPI:1669100509
Name:BIGELOW COUNSELING & THERAPY SERVICES, PLC
Entity type:Organization
Organization Name:BIGELOW COUNSELING & THERAPY SERVICES, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGELOW
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:319-610-9995
Mailing Address - Street 1:3641 KIMBALL AVE # 204
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50702-5757
Mailing Address - Country:US
Mailing Address - Phone:319-610-9995
Mailing Address - Fax:
Practice Address - Street 1:3641 KIMBALL AVE # 204
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50702-5757
Practice Address - Country:US
Practice Address - Phone:319-610-9995
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-09
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)