Provider Demographics
NPI:1013306224
Name:INTUITIVE HEART COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:INTUITIVE HEART COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MRS
Authorized Official - First Name:PENNY
Authorized Official - Middle Name:JO
Authorized Official - Last Name:NICHOLS-PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-802-7348
Mailing Address - Street 1:4517 49TH PL
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-2969
Mailing Address - Country:US
Mailing Address - Phone:515-802-7348
Mailing Address - Fax:515-255-3944
Practice Address - Street 1:6955 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1540
Practice Address - Country:US
Practice Address - Phone:515-802-7348
Practice Address - Fax:515-255-3944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0072601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty