The Healing Space Counseling Center, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

06533 Issued in IA

Legal business name

THE HEALING SPACE COUNSELING CENTER, LLC

Practice address

3810 1/2 Douglas Ave
Des Moines, IA 50310-3610

Phone

(515) 423-2333

NPI assigned

Mar 19, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tiffany Bandow, LISW

Title

Owner

Phone

(515) 423-2333

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426723200000",
    "number": "1033503768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3810 1/2 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103610",
            "telephone_number": "515-423-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3810 1/2 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503103610",
            "telephone_number": "515-423-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE HEALING SPACE COUNSELING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-19",
        "last_updated": "2015-03-19",
        "status": "A",
        "authorized_official_last_name": "BANDOW",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-423-2333",
        "authorized_official_credential": "LISW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "06533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.