Healthcare Provider Details

I. General information

NPI: 1932083896
Provider Name (Legal Business Name): JENNIFER GAGE LMFT LLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2025
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 3RD AVE SE STE 311
CEDAR RAPIDS IA
52401-1408
US

IV. Provider business mailing address

118 3RD AVE SE STE 311
CEDAR RAPIDS IA
52401-1408
US

V. Phone/Fax

Practice location:
  • Phone: 319-775-0007
  • Fax:
Mailing address:
  • Phone: 319-775-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

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

VIII. Authorized Official

Name: JENNIFER GAGE
Title or Position: PROVIDER/OWNER
Credential:
Phone: 319-775-0007