Healthcare Provider Details

I. General information

NPI: 1881466225
Provider Name (Legal Business Name): AJ AND J THERAPY AND CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2023
Last Update Date: 10/30/2023
Certification Date: 10/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 SW 4TH ST STE 114
ANKENY IA
50023-2964
US

IV. Provider business mailing address

702 SW 4TH ST STE 114
ANKENY IA
50023-2964
US

V. Phone/Fax

Practice location:
  • Phone: 515-368-9966
  • Fax: 515-478-7264
Mailing address:
  • Phone: 515-368-9966
  • Fax: 515-478-7264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALEXANDRA JORDAHL-JOHNSON
Title or Position: MANAGER/THERAPIST
Credential: LMHC
Phone: 515-368-9966