Healthcare Provider Details

I. General information

NPI: 1891217196
Provider Name (Legal Business Name): NAOMI LOUISE MANSON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2017
Last Update Date: 08/21/2024
Certification Date: 08/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

373 COLLINS RD NE STE 210
CEDAR RAPIDS IA
52402-3167
US

IV. Provider business mailing address

373 COLLINS RD NE STE 210
CEDAR RAPIDS IA
52402-3167
US

V. Phone/Fax

Practice location:
  • Phone: 319-240-2918
  • Fax: 319-483-6506
Mailing address:
  • Phone: 319-240-2918
  • Fax: 319-483-6506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number075517
License Number StateIA

VII. Legacy identifiers

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: