Provider Demographics
NPI:1386168722
Name:ALYSSA DRURY COUNSELING LLC
Entity type:Organization
Organization Name:ALYSSA DRURY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DRURY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CADC
Authorized Official - Phone:319-521-1333
Mailing Address - Street 1:52 STURGIS CORNER DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-5617
Mailing Address - Country:US
Mailing Address - Phone:319-423-9340
Mailing Address - Fax:
Practice Address - Street 1:52 STURGIS CORNER DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-5617
Practice Address - Country:US
Practice Address - Phone:319-423-9340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00928251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1538235379Medicaid