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General NPI Number Information
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NPI Number | 1467253195
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Entity Type | Individual
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Provider Name | ALYSSA ELGERSMA
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Gender | Female
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Dates
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Enumeration Date | 03/19/2025
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 2540 106TH ST STE 202
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City | URBANDALE
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State | IA
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Zip | 50322-3736
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Country | US
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Telephone | 515-635-1805
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Fax |
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Provider Business Mailing Address
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Address Line | 621 W MILLS ST
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City | WINTERSET
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State | IA
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Zip | 50273-1074
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Country | US
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Telephone | 515-212-5055
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPCC.0021757
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 128932
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License Number State | IA
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