Healthcare Provider Details

I. General information

NPI: 1518876390
Provider Name (Legal Business Name): STACEY HARMSEN MA, TLMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

4403 1ST AVE SE STE 501
CEDAR RAPIDS IA
52402-3222
US

IV. Provider business mailing address

2500 VICTORIA ST
MARION IA
52302-6605
US

V. Phone/Fax

Practice location:
  • Phone: 319-214-0769
  • Fax:
Mailing address:
  • Phone: 319-361-8200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number138797
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: