Provider Demographics
NPI:1710387303
Name:VANHOUTEN-GREEDY, LOA (PLMHP/PLADC)
Entity Type:Individual
Prefix:
First Name:LOA
Middle Name:
Last Name:VANHOUTEN-GREEDY
Suffix:
Gender:F
Credentials:PLMHP/PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 WEST ST
Mailing Address - Street 2:
Mailing Address - City:TABOR
Mailing Address - State:IA
Mailing Address - Zip Code:51653-4065
Mailing Address - Country:US
Mailing Address - Phone:712-313-0067
Mailing Address - Fax:402-697-3924
Practice Address - Street 1:608 WEST ST
Practice Address - Street 2:
Practice Address - City:TABOR
Practice Address - State:IA
Practice Address - Zip Code:51653-4065
Practice Address - Country:US
Practice Address - Phone:712-313-0067
Practice Address - Fax:402-697-3924
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-02
Last Update Date:2014-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-1154101YA0400X
NE10311101YM0800X
8921101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)