Healthcare Provider Details

I. General information

NPI: 1881183390
Provider Name (Legal Business Name): SUSAN CHRISTINE BOCK LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3726 QUEEN CT SW STE 103
CEDAR RAPIDS IA
52404-3903
US

IV. Provider business mailing address

2272 SUGAR BOTTOM RD NE
SOLON IA
52333-9589
US

V. Phone/Fax

Practice location:
  • Phone: 319-560-0230
  • Fax: 319-343-1059
Mailing address:
  • Phone: 319-624-2301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number085238
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: