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Organization

KANESVILLE THERAPY LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CAROLYN ANN ANDERSEN BURGHER MS LMHC LMHP LIMHP (MENTAL HEALTH COUNSELOR)
(712) 328-9205
Entity
Organization

Contact information

Practice address
35 MAIN PLACE, SUITE 100 OMNI CENTER BUSINESS PARK, COUNCIL BLUFFS, IA 51503
(712) 328-9205
Mailing address
16 LOCUST LODGE, COUNCIL BLUFFS, IA 51503
(712) 328-9205

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
00169
IA
101YM0800X
Mental Health Counselor
1750
NE
101YM0800X
Mental Health Counselor
376
NE

Other

Enumeration date
01/21/2008
Last updated
04/28/2008
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