Provider Demographics
NPI:1255222816
Name:SRG COUNSELING AND ASSESSMENT SERVICES, LLC
Entity type:Organization
Organization Name:SRG COUNSELING AND ASSESSMENT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GAUGER
Authorized Official - Suffix:
Authorized Official - Credentials:MSSW
Authorized Official - Phone:515-778-9658
Mailing Address - Street 1:7405 UNIVERSITY AVE. SUITE 6, CLIVE, IA 50325
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325
Mailing Address - Country:US
Mailing Address - Phone:515-778-9658
Mailing Address - Fax:515-277-6995
Practice Address - Street 1:7405 UNIVERSITY AVE. SUITE 6
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325
Practice Address - Country:US
Practice Address - Phone:515-277-3101
Practice Address - Fax:515-277-6995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health