Provider Demographics
NPI:1861271470
Name:ELEMENTAL EMDR & MORE, PC
Entity type:Organization
Organization Name:ELEMENTAL EMDR & MORE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELPHINE
Authorized Official - Middle Name:LINDA
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-520-9378
Mailing Address - Street 1:12051 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8226
Mailing Address - Country:US
Mailing Address - Phone:515-520-9378
Mailing Address - Fax:
Practice Address - Street 1:2425 N ANKENY BLVD STE 106
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4722
Practice Address - Country:US
Practice Address - Phone:515-520-9378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-22
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty