Healthcare Provider Details

I. General information

NPI: 1881506921
Provider Name (Legal Business Name): JESSICA BOEKHOFF MS, TLMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

383 COLLINS RD NE STE 110
CEDAR RAPIDS IA
52402-3147
US

IV. Provider business mailing address

1372 38TH ST SE
CEDAR RAPIDS IA
52403-3838
US

V. Phone/Fax

Practice location:
  • Phone: 319-382-8664
  • Fax:
Mailing address:
  • Phone: 319-382-8664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number139928
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: