MEDICARE: AMY J. UGULINI PALS LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	001258	IA
2	101Y00000X	Counselor

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033365549
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY J. UGULINI PALS LMHC

Provider Business Mailing Address
First Line	:	1200 VALLEY WEST DR STE 204
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1902
Country	:	US
Telephone Number	:	515-518-0412
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 VALLEY WEST DR STE 204
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1902
Country	:	US
Telephone Number	:	515-518-0412
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2008
Last Update Date	:	05/12/2020

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