MEDICARE: ACCESS EVALUATION AND EDUCATION SERVICES, L.L.C.

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
2	104100000X	Social Worker
3	207QA0401X	Addiction Medicine (Family Medicine) Physician
4	251S00000X	Community/Behavioral Health Agency	1401	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932633609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACCESS EVALUATION AND EDUCATION SERVICES, L.L.C.

Provider Business Mailing Address
First Line	:	3640 CANTERBURY CT
Second Line	:
City	:	WATERLOO
State	:	IA
Zip	:	50702-5705
Country	:	US
Telephone Number	:	319-252-4631
Fax Number	:	181-421-2449

Provider Business Practice Location Address
First Line	:	3640 CANTERBURY CT
Second Line	:
City	:	WATERLOO
State	:	IA
Zip	:	50702-5705
Country	:	US
Telephone Number	:	319-252-4631
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ DIRECTOR
Name	:	AMY RENEE BONEBRAKE
Credential	:	MSW, CADC, SAP
Telephone Number	:	319-252-4631

Provider Enumeration Date	:	04/19/2017
Last Update Date	:	07/17/2023

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Directions to “ACCESS EVALUATION AND EDUCATION SERVICES, L.L.C. ” Practice Location

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