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Individual

MR. DOUGLAS ALAN BRINK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LISW, LMFT

Contact information

Practice address
202 1ST ST SE, SUITE 107, MASON CITY, IA 50401-3946
(641) 423-3778
(641) 423-3881
Mailing address
202 1ST ST SE, SUITE 107, MASON CITY, IA 50401-3946
(641) 423-3778
(641) 423-3881

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
05899
IA
106H00000X
Marriage & Family Therapist
0378
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0446336
IA
01
72639
WELLMARK BLUE CROSS BLUE SHIELD
IA
Enumeration date
06/16/2005
Last updated
08/12/2013
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