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General NPI Number Information
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NPI Number | 1467065235
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Entity Type | Organization
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Legal Business Name | GRIEF COUNSELING AND THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 08/31/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 2435 EAST KIMBERLY RD SUITE 300 SOUTH
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City | BETTENDORF
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State | IA
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Zip | 52722-3509
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Country | US
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Telephone | 319-750-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 2435 EAST KIMBERLY RD SUITE 300 SOUTH
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City | BETTENDORF
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State | IA
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Zip | 52722
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Country | US
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Telephone | 319-750-8525
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | JULIE BOCKENSTEDT
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Credential | PHD, LCSW
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Telephone | 319-750-8525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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