Provider Demographics
NPI:1942649793
Name:BALES, DIANE KAY (LMHC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:KAY
Last Name:BALES
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 NE MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:EARLHAM
Mailing Address - State:IA
Mailing Address - Zip Code:50072-1065
Mailing Address - Country:US
Mailing Address - Phone:641-780-2718
Mailing Address - Fax:
Practice Address - Street 1:3115 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5307
Practice Address - Country:US
Practice Address - Phone:515-235-4720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-14
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health