Provider Demographics
NPI:1437580842
Name:VINCHATTLE, LINDA M (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:M
Last Name:VINCHATTLE
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 NE 14TH ST STE 36
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8903
Mailing Address - Country:US
Mailing Address - Phone:612-296-0152
Mailing Address - Fax:
Practice Address - Street 1:6950 NE 14TH ST STE 36
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8903
Practice Address - Country:US
Practice Address - Phone:612-296-0152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-10
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2397106H00000X
IA083309106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist