# SEASONS CENTER FOR MENTAL HEALTH

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

## Provider details

- **NPI number:** 1487900965
- **Authorized official:** MRS. BRENNA A. KOEDAM LMHC, IADC (SUBSTANCE ABUSE SERVICES SUPERVISOR)
- **Authorized official phone:** (800) 242-5101

## Contact information

- **Practice address:** 201 E 11TH ST, SPENCER, IA 51301-4436
- **Practice address phone:** (800) 242-5101
- **Practice address fax:** (712) 264-3177
- **Mailing address:** 201 E 11TH ST, SPENCER, IA 51301-4436
- **Mailing address phone:** (800) 242-5101
- **Mailing address fax:** (712) 264-3177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 05041 | IA | Yes |
| 101YM0800X | Mental Health Counselor | 001530 | IA | — |

## Other

- **Enumeration date:** 08/02/2012
- **Last updated:** 08/02/2012