MEDICARE: NAOMI LOUISE MANSON LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	075517	IA

General Provider Information

NPI Number	:	1891217196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI LOUISE MANSON LMHC

Provider Business Mailing Address
First Line	:	373 COLLINS RD NE STE 210
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3167
Country	:	US
Telephone Number	:	319-240-2918
Fax Number	:	319-483-6506

Provider Business Practice Location Address
First Line	:	373 COLLINS RD NE STE 210
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3167
Country	:	US
Telephone Number	:	319-240-2918
Fax Number	:	319-483-6506

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2017
Last Update Date	:	08/21/2024

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