# JENNIFER L. STREETS GLADWIN, LLC

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

## Provider details

- **NPI number:** 1609151158
- **Authorized official:** JENNIFER L. STREETS GLADWIN LCPC, LMHC (OWNER)
- **Authorized official phone:** (309) 507-1791

## Contact information

- **Practice address:** 3481 UTICA RIDGE RD, BETTENDORF, IA 52722-1617
- **Practice address phone:** (309) 507-1791
- **Mailing address:** 3481 UTICA RIDGE RD, BETTENDORF, IA 52722-1617
- **Mailing address phone:** (309) 507-1791

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 001200 | IA | Yes |

## Other

- **Enumeration date:** 10/17/2011
- **Last updated:** 10/17/2011