Organization
SEASONS CENTER FOR MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENNA A. KOEDAM LMHC, IADC (SUBSTANCE ABUSE SERVICES SUPERVISOR)
(800) 242-5101
Entity
Organization
Contact information
Practice address
201 E 11TH ST, SPENCER, IA 51301-4436
(800) 242-5101
(712) 264-3177
Mailing address
201 E 11TH ST, SPENCER, IA 51301-4436
(800) 242-5101
(712) 264-3177
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
05041
IA
101YM0800X
Mental Health Counselor
001530
IA
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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