The Lodge Counseling & Consuliting

NPI #1629359872 in Sioux City, Iowa

Provider Information

NPI Number: 1629359872
Entity Type: Organization
Organization Name: The Lodge Counseling & Consuliting
Primary Specialty: Counselor
Enumeration Date: Sep 1, 2011
Last Updated: Sep 1, 2011

Practice Location

Address: 705 DOUGLAS ST
Address 2: SUITE # 208
City: Sioux City
State: Iowa
ZIP Code: 51101-1048
Phone: (712) 259-5134

Authorized Official

Name: MR. VINCENT MAHON
Title: CO-OWNER
Phone: (712) 259-5134

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Social Worker - Clinical — Clinical	1041C0700X
Counselor	101Y00000X	Primary

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