Healthcare Provider Details

I. General information

NPI: 1417647454
Provider Name (Legal Business Name): CASSANDRA ALDERMAN TLMHC, CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2023
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3251 W 9TH ST
WATERLOO IA
50702-5310
US

IV. Provider business mailing address

3251 W 9TH ST
WATERLOO IA
50702-5310
US

V. Phone/Fax

Practice location:
  • Phone: 319-234-2893
  • Fax:
Mailing address:
  • Phone: 319-234-2893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number23050
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number116879
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: