Provider Demographics
NPI:1740746130
Name:AUDREY WHEELER, LMHC, RPT, LLC
Entity type:Organization
Organization Name:AUDREY WHEELER, LMHC, RPT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHEELER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:641-324-6378
Mailing Address - Street 1:222 E CASS ST
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1467
Mailing Address - Country:US
Mailing Address - Phone:402-917-1427
Mailing Address - Fax:
Practice Address - Street 1:134 W JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1286
Practice Address - Country:US
Practice Address - Phone:641-324-6378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-11
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty