Provider Demographics
NPI:1952192783
Name:AYAS PSYCHOTHERAPEUTIC INTERVENTIONS LLC
Entity type:Organization
Organization Name:AYAS PSYCHOTHERAPEUTIC INTERVENTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:WEISCH
Authorized Official - Suffix:
Authorized Official - Credentials:CCMHC, LCPC, LMHC
Authorized Official - Phone:406-220-6262
Mailing Address - Street 1:2117 STATE ST STE 250
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-5164
Mailing Address - Country:US
Mailing Address - Phone:406-220-6262
Mailing Address - Fax:
Practice Address - Street 1:2117 STATE ST STE 250
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-5164
Practice Address - Country:US
Practice Address - Phone:406-220-6262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA090936OtherSTATE LICENSE
IL180.013607OtherSTATE LICENSE