Active NPI
Tiffany Theulen, TLMHC
- Mental Health Counselor
- Des Moines, IA
National Provider Identifier
1497463376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 113128
- Practice address
- 3451 Easton Blvd
Des Moines, IA 50317-3214 - Phone
- (515) 262-0349
- NPI assigned
- Nov 9, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 113128 | IA | Primary |
Addresses
Primary practice location
3451 Easton Blvd
Des Moines, IA 50317-3214
Mailing address
3451 Easton Blvd
Des Moines, IA 50317-3214
Phone (515) 262-0349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113128 | IA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1667952000000",
"number": "1497463376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3451 EASTON BLVD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503173214",
"telephone_number": "515-262-0349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3451 EASTON BLVD",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503173214",
"telephone_number": "515-262-0349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEULEN",
"first_name": "TIFFANY",
"credential": "TLMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-09",
"last_updated": "2022-11-09",
"certification_date": "2022-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IA",
"license": "113128",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.