Healthcare Provider Details

I. General information

NPI: 1649081845
Provider Name (Legal Business Name): SJL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2025
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 W 1ST ST
CEDAR FALLS IA
50613-2617
US

IV. Provider business mailing address

246 MORRELL AVE
EVANSDALE IA
50707-1031
US

V. Phone/Fax

Practice location:
  • Phone: 319-420-2687
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: SHANNON LENTFER
Title or Position: OWNER
Credential: LISW
Phone: 319-420-2687