Organization
CORRIDOR COUNSELING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN RYAN LEEFERS LMFT (THERAPIST/OWNER & SOLE MEMBER)
(319) 270-0019
Entity
Organization
Contact information
Practice address
4403 1ST AVE SE, CEDAR RAPIDS, IA 52402-3200
(319) 270-0019
(319) 294-7032
Mailing address
PO BOX 1561, CEDAR RAPIDS, IA 52406-1561
(319) 270-0019
(319) 294-7032
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
Primary
000435
IA
225XM0800X
Mental Health Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154713964
—
IA
Enumeration date
07/06/2017
Last updated
07/06/2017
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