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General NPI Number Information
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NPI Number | 1477423275
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Entity Type | Organization
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Legal Business Name | DE NOVO COUNSELING & THERAPY, LLC
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Dates
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Enumeration Date | 11/06/2025
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 2421 CORAL CT STE 129
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City | CORALVILLE
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State | IA
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Zip | 52241-2886
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Country | US
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Telephone | 319-322-8887
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Fax |
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Provider Business Mailing Address
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Address Line | 761 CAMP CARDINAL BLVD # 2271
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City | CORALVILLE
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State | IA
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Zip | 52241-2893
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Country | US
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Telephone | 319-322-8887
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | MS. KIMBERLY KAY ANDERSON
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Credential | LISW
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Telephone | 319-594-8010
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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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