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Organization
CHILDREN OF PROMISE MENTORING PROGRAM
Active
Organization
CHILDREN OF PROMISE MENTORING PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL PLEDGEJOHNSON MSW (BEHAVIOR HEALTH COUNSELOR)
(319) 529-1543
Entity
Organization
Contact information
Practice address
1030 5TH AVE SE STE 1200, CEDAR RAPIDS, IA 52403-2428
(319) 529-1543
Mailing address
1143 LONGFELLOW AVE, WATERLOO, IA 50703-1720
(319) 529-1543
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
Other
Enumeration date
02/16/2023
Last updated
02/16/2023
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