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General NPI Number Information
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NPI Number | 1366943615
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Entity Type | Organization
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Legal Business Name | NEXUS COUNSELING SERVICE PLLC
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Dates
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Enumeration Date | 02/22/2018
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Last Update Date | 02/22/2018
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Provider Practice Location Address
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Address Line | 1501 42ND ST ONE CORPORATE PLACE STE 210
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City | WEST DES MOINES
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State | IA
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Zip | 50266-1005
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Country | US
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Telephone | 515-333-9734
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Fax | 515-226-8433
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Provider Business Mailing Address
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Address Line | P.O. BOX 35944
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City | DES MOINES
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State | IA
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Zip | 50315-0326
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Country | US
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Telephone | 515-333-9734
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Fax | 515-226-8433
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. BRIAN TODD ELLIS
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Credential | LMSW
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Telephone | 515-333-9734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 087137
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License Number State | IA
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