# CHILDREN OF PROMISE MENTORING PROGRAM

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265130587
- **Authorized official:** MR. DANIEL PLEDGEJOHNSON MSW (BEHAVIOR HEALTH COUNSELOR)
- **Authorized official phone:** (319) 529-1543

## Contact information

- **Practice address:** 1030 5TH AVE SE STE 1200, CEDAR RAPIDS, IA 52403-2428
- **Practice address phone:** (319) 529-1543
- **Mailing address:** 1143 LONGFELLOW AVE, WATERLOO, IA 50703-1720
- **Mailing address phone:** (319) 529-1543

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |

## Other

- **Enumeration date:** 02/16/2023
- **Last updated:** 02/16/2023