Healthcare Provider Details

I. General information

NPI: 1386508984
Provider Name (Legal Business Name): MODERN COUNSELING SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E MAIN ST
WASHINGTON IA
52353-2012
US

IV. Provider business mailing address

PO BOX 621
WASHINGTON IA
52353-0621
US

V. Phone/Fax

Practice location:
  • Phone: 515-612-6921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER BETSWORTH
Title or Position: OWNER
Credential:
Phone: 515-612-6921