Organization
ASCEND THERAPEUTIC AND WELLNESS SERVICES OF IOWA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACIE SELF LMHC (OWNER)
(319) 318-2250
Entity
Organization
Contact information
Practice address
729 PARK AVE, ACKLEY, IA 50601-1539
(319) 318-2250
Mailing address
809 GRAY ST, APLINGTON, IA 50604-1030
(319) 318-2250
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120316
—
IA
Enumeration date
02/03/2019
Last updated
02/03/2019
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