Basic Information
| Provider Information | |||||||||
| NPI: | 1255920468 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NEVIUS | ||||||||
| FirstName: | KEIFER | ||||||||
| MiddleName: | PAUL | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1424 OAK PARK AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503133018 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5156815959 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 6200 AURORA AVE STE 103E | ||||||||
| Address2: | |||||||||
| City: | URBANDALE | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503226338 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5154016886 | ||||||||
| FaxNumber: | 5154015237 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2021 | ||||||||
| LastUpdateDate: | 01/12/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 105955 | IA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.