Active NPI
Headwaters Integrative Center LLC
- Mental Health Counselor
- Spirit Lake, IA
National Provider Identifier
1942119573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Legal business name
- HEADWATERS INTEGRATIVE CENTER LLC
- Practice address
- 3008 18TH St
Spirit Lake, IA 51360-7471 - Phone
- (712) 330-8090
- NPI assigned
- Sep 1, 2026
- Last updated
- Sep 1, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ruth McCleery
- Title
- Ceo
- Phone
- (712) 330-8090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3008 18TH St
Spirit Lake, IA 51360-7471
Mailing address
3008 18TH St
Spirit Lake, IA 51360-7471
National Provider Directory
National Provider DirectoryLocations
3008 18th St
Spirit Lake, IA 51360
Phone (712) 330-8090
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788220800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788220800000",
"number": "1942119573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3008 18TH ST",
"city": "SPIRIT LAKE",
"state": "IA",
"postal_code": "513607471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3008 18TH ST",
"city": "SPIRIT LAKE",
"state": "IA",
"postal_code": "513607471",
"telephone_number": "712-330-8090"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEADWATERS INTEGRATIVE CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-01",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A",
"authorized_official_last_name": "MCCLEERY",
"authorized_official_first_name": "RUTH",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "712-330-8090"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spirit Lake, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.