MEDICARE: MARY BOOTS IADC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	11063	IA

General Provider Information

NPI Number	:	1740602770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY BOOTS IADC

Provider Business Mailing Address
First Line	:	4403 1ST AVE SE STE 307
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3221
Country	:	US
Telephone Number	:	319-294-1599
Fax Number	:

Provider Business Practice Location Address
First Line	:	4403 1ST AVE SE STE 307
Second Line	:
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52402-3221
Country	:	US
Telephone Number	:	319-294-1599
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2014
Last Update Date	:	01/10/2014

Similar Medicare Providers

1215307111 — CHRISTINA LEA AQUINO LISW
Practice Location Address:

4403 1ST AVE SE STE 416
CEDAR RAPIDS, IA
52402-3221

Practice Phone: 641-781-0538
Practice Fax:

1245990878 — JEANNEMARIE FOURNIER ARNP
Practice Location Address:

4403 1ST AVE SE STE 220
CEDAR RAPIDS, IA
52402-3221

Practice Phone: 319-900-4525
Practice Fax: 319-303-7070

1881690667 — CHRISTINE MARIE SIGWARTH L.M.H.C.
Practice Location Address:

4403 1ST AVE SE , STE 518
CEDAR RAPIDS, IA
52402-3221

Practice Phone: 319-363-4775
Practice Fax: 319-363-4775

1780671339 — DR. KATHRYN R BROWN DC
Practice Location Address:

4403 1ST AVE SE , STE 304
CEDAR RAPIDS, IA
52402-3221

Practice Phone: 319-393-0911
Practice Fax:

1770767428 — DR. CHRISTINA LIN COUCH PSY.D.
Practice Location Address:

4403 1ST AVE SE STE 309
CEDAR RAPIDS, IA
52402-3221

Practice Phone: 319-693-6996
Practice Fax: 888-529-6759

1114102415 — ALL HEART STAFFING, INC.
Practice Location Address:

4403 1ST AVE SE STE 310
CEDAR RAPIDS, IA
52402-3221

Practice Phone: 319-241-7560
Practice Fax: 319-294-9593

Directions to “ MARY BOOTS IADC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.