# SELF-AWARENESS, LLC

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

## Provider details

- **NPI number:** 1336538180
- **Authorized official:** MR. JEROME MILLER B.S., CADC (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (515) 277-0320

## Contact information

- **Practice address:** 2301 FOREST AVE, DES MOINES, IA 50311-3113
- **Practice address phone:** (515) 277-0320
- **Mailing address:** 2301 FOREST AVE, DES MOINES, IA 50311-3113
- **Mailing address phone:** (515) 277-0320

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 14007 | IA | Yes |

## Other

- **Enumeration date:** 01/16/2015
- **Last updated:** 01/16/2015