Provider Demographics
NPI:1992519805
Name:RESTORATION COUNSELING LLC
Entity type:Organization
Organization Name:RESTORATION COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINCIAN
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:A
Authorized Official - Last Name:POTTORFF
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, CADC
Authorized Official - Phone:713-837-6294
Mailing Address - Street 1:8450 HICKMAN RD STE 10
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-4307
Mailing Address - Country:US
Mailing Address - Phone:713-837-6294
Mailing Address - Fax:
Practice Address - Street 1:8450 HICKMAN RD STE 10
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-4307
Practice Address - Country:US
Practice Address - Phone:713-837-6294
Practice Address - Fax:515-318-5232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty