Provider Demographics
NPI:1598948572
Name:EMPLOYEE AND FAMILY COUNSLEING CENTER
Entity type:Organization
Organization Name:EMPLOYEE AND FAMILY COUNSLEING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRIET
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHELPS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:563-381-8088
Mailing Address - Street 1:PO BOX 2783
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52809-2783
Mailing Address - Country:US
Mailing Address - Phone:563-381-8088
Mailing Address - Fax:563-823-8694
Practice Address - Street 1:718 BRIDGE AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52803-5620
Practice Address - Country:US
Practice Address - Phone:563-381-8088
Practice Address - Fax:563-823-8694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA238252OtherMIDLAND'S CHOICE
IA36005OtherWELLMARK
IA396294OtherVALUE OPTIONS RAILROAD
IA0457481Medicaid
IA216358OtherIOWA HEALTH
IA18181Medicare PIN