Healthcare Provider Details

I. General information

NPI: 1659186112
Provider Name (Legal Business Name): MARGARET SUE GORTER TLMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

922 RAINBOW DR STE 101
CEDAR FALLS IA
50613-6500
US

IV. Provider business mailing address

307 FLORENCE ST
PARKERSBURG IA
50665-2084
US

V. Phone/Fax

Practice location:
  • Phone: 319-290-1550
  • Fax:
Mailing address:
  • Phone: 319-415-0286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number130417
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: