Healthcare Provider Details
I. General information
NPI: 1801512116
Provider Name (Legal Business Name): OLIVE BRANCH COUNSELING SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
215 FRANKLIN ST
CEDAR FALLS IA
50613-2746
US
IV. Provider business mailing address
2418 WILLOW LN
CEDAR FALLS IA
50613-5908
US
V. Phone/Fax
- Phone: 319-804-8584
- Fax:
- Phone: 563-422-7773
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical 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:
EMILY
STEFFEN
Title or Position: PARTNER
Credential: LISW
Phone: 563-422-7773