Brink, Douglas Alan

Brink, Douglas Alan is an sole proprietor health care provider with primary practice located at 202 1St St Se Suite 107, Mason City IA 50401-3946. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Brink, Douglas Alan can be contacted via phone (641) 423-3778.

Contact Information

Primary practice address
202 1St St Se Suite 107 Mason City IA 50401-3946
Phone: (641) 423-3778
Fax: (641) 423-3881
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 05899 Iowa
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0378 Minnesota

Profile Details

NPI number 1023013174
LBN Legal business name Brink, Douglas Alan
Credentials LISW, LMFT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2005
Last updated Aug 12th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023013174 NPPES
Iowa MEDICAID 0446336
Iowa Other 72639

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