Provider Demographics
NPI:1548016595
Name:DEBOOM THERAPY & CONSULTING, INC
Entity type:Organization
Organization Name:DEBOOM THERAPY & CONSULTING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DRAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:515-531-0800
Mailing Address - Street 1:2100 WESTOWN PKWY STE 230
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1539
Mailing Address - Country:US
Mailing Address - Phone:515-531-0800
Mailing Address - Fax:515-531-0900
Practice Address - Street 1:2100 WESTOWN PKWY STE 230
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-1539
Practice Address - Country:US
Practice Address - Phone:515-531-0800
Practice Address - Fax:515-531-0900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0140144Medicaid