Organization
YOUR SELF-CARE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M DEROOS (OWNER)
(402) 882-0583
Entity
Organization
Contact information
Practice address
300 W BROADWAY STE 240, COUNCIL BLUFFS, IA 51503-9028
(402) 882-0583
(712) 254-8829
Mailing address
PO BOX 780, COUNCIL BLUFFS, IA 51502-0780
(402) 882-0583
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0707101
—
IA
Enumeration date
04/06/2020
Last updated
11/12/2025
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