Healthcare Provider Details

I. General information

NPI: 1134779218
Provider Name (Legal Business Name): JESSICA REGI STUHRENBERG LMFT, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JESSICA REGI GROSS TMFT, CADC

II. Dates (important events)

Enumeration Date: 09/19/2019
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 DIAMOND ST.
ONAWA IA
51040
US

IV. Provider business mailing address

1600 DIAMOND ST.
ONAWA IA
51040
US

V. Phone/Fax

Practice location:
  • Phone: 712-423-9160
  • Fax: 712-423-9164
Mailing address:
  • Phone: 712-423-9160
  • Fax: 712-423-9164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: