Healthcare Provider Details
I. General information
NPI: 1912860420
Provider Name (Legal Business Name): 319 THERAPY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1435 31ST ST NE STE A
CEDAR RAPIDS IA
52402-4056
US
IV. Provider business mailing address
1435 31ST ST NE STE A
CEDAR RAPIDS IA
52402-4056
US
V. Phone/Fax
- Phone: 864-497-2294
- Fax:
- Phone: 864-497-2294
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 106H00000X |
| Taxonomy | Marriage & Family Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LAUREN
CLAYTON
WOOD
Title or Position: MARRIAGE AND FAMILY THERAPIST
Credential: PH.D., LMFT
Phone: 864-497-2294