Healthcare Provider Details

I. General information

NPI: 1679826994
Provider Name (Legal Business Name): ELISE HEALZER MA, LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 12/21/2025
Certification Date: 12/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5127 24TH AVENUE DR
BRANDON IA
52210-9632
US

IV. Provider business mailing address

5127 24TH AVENUE DR
BRANDON IA
52210-9632
US

V. Phone/Fax

Practice location:
  • Phone: 319-361-7417
  • Fax:
Mailing address:
  • Phone: 319-361-7417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number000382
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: