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General NPI Number Information
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NPI Number | 1528955382
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Entity Type | Organization
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Legal Business Name | NORTH STAR WELLNESS SERVICES
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Dates
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Enumeration Date | 06/23/2025
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 543 E GOLDFINCH DR
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City | TIFFIN
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State | IA
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Zip | 52340-4706
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Country | US
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Telephone | 319-930-5104
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 105
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City | TIFFIN
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State | IA
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Zip | 52340-0105
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Country | US
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Telephone | 319-930-5104
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JENNIFER LURIA
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Credential | MSW, LCSW, LISW
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Telephone | 319-930-5104
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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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