Healthcare Provider Details

I. General information

NPI: 1124945977
Provider Name (Legal Business Name): JENNIFER BELKEN TCADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1812 24TH AVE W
SPENCER IA
51301-2661
US

IV. Provider business mailing address

1812 24TH AVE W
SPENCER IA
51301-2661
US

V. Phone/Fax

Practice location:
  • Phone: 712-580-3030
  • Fax: 712-580-3040
Mailing address:
  • Phone: 712-580-3030
  • Fax: 712-580-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: