Individual
GAYLE HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LMHC, LCPC, CADC
Contact information
Practice address
3601 16TH AVE SW, CEDAR RAPIDS, IA 52404-2328
(319) 390-4611
Mailing address
3601 16TH AVE SW, CEDAR RAPIDS, IA 52404-2328
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01064
IA
101YM0800X
Mental Health Counselor
00675
IA
101YM0800X
Mental Health Counselor
180-001471
IL
Other
Enumeration date
04/05/2018
Last updated
04/05/2018
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