Healthcare Provider Details

I. General information

NPI: 1841124880
Provider Name (Legal Business Name): ELMSTEAD COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3336 KIMBALL AVE STE 153
WATERLOO IA
50702-5759
US

IV. Provider business mailing address

3336 KIMBALL AVE STE 153
WATERLOO IA
50702-5759
US

V. Phone/Fax

Practice location:
  • Phone: 319-595-4646
  • Fax:
Mailing address:
  • Phone: 319-595-4646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMANDA MARKS
Title or Position: OWNER
Credential: LMHC
Phone: 319-595-4646