MEDICARE: CONNECTION IS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1073118188
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTION IS, LLC

Provider Business Mailing Address
First Line	:	305 2ND AVE SE STE 200
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-1207
Country	:	US
Telephone Number	:	319-214-3377
Fax Number	:	319-774-0344

Provider Business Practice Location Address
First Line	:	305 2ND AVE SE STE 200
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52401-1207
Country	:	US
Telephone Number	:	319-214-3377
Fax Number	:	319-774-0344

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MS. ANNE LINDYBERG
Credential	:	LMHC
Telephone Number	:	319-214-3377

Provider Enumeration Date	:	12/04/2020
Last Update Date	:	12/04/2020

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