Healthcare Provider Details
I. General information
NPI: 1083388672
Provider Name (Legal Business Name): SEEDS OF HOPE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/06/2021
Last Update Date: 04/08/2022
Certification Date: 04/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
205 N B ST STE A
FAIRFIELD IA
52556-2944
US
IV. Provider business mailing address
205 N B ST STE A
FAIRFIELD IA
52556-2944
US
V. Phone/Fax
- Phone: 641-233-7262
- Fax:
- Phone: 641-200-1514
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| 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: MRS.
MELISSA
E
HUFF
Title or Position: MENTAL HEALTH THERAPIST/OWNER
Credential: LISW
Phone: 641-200-1514