Organization
CCST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY SUE NELSON LISW (OWNER OF BUSINESS)
(515) 291-1499
Entity
Organization
Contact information
Practice address
2521 ELWOOD DR, SUITE 121, AMES, IA 50010-8229
(515) 291-1499
(515) 292-2184
Mailing address
2521 ELWOOD DR, SUITE 121, AMES, IA 50010-8229
(515) 291-1499
(515) 292-2184
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
06044
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045 9909
IA MCAID ENT W DSM IA
IA
05
—
145 9909
—
IA
01
—
244574
MIDLANDS CHOICE
IA
01
—
36996
B CROSS B SHIELD WELLMARK
IA
Enumeration date
06/25/2006
Last updated
08/22/2020
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