Provider Demographics
NPI:1518036862
Name:LOESCH, DIANA K (LPC LMHC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:K
Last Name:LOESCH
Suffix:
Gender:F
Credentials:LPC LMHC
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA PLPC
Mailing Address - Street 1:1912 SW CASCADE FALLS DR
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7098
Mailing Address - Country:US
Mailing Address - Phone:573-256-9293
Mailing Address - Fax:
Practice Address - Street 1:1409 CLARK ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1964
Practice Address - Country:US
Practice Address - Phone:515-643-6502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006005206101Y00000X
IA082956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor