Healthcare Provider Details

I. General information

NPI: 1023942158
Provider Name (Legal Business Name): INTROSPECTIVE COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 MARYLAND PIKE
DES MOINES IA
50310-3430
US

IV. Provider business mailing address

2505 MARYLAND PIKE
DES MOINES IA
50310-3430
US

V. Phone/Fax

Practice location:
  • Phone: 515-707-7966
  • Fax:
Mailing address:
  • Phone: 515-707-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SARAH FANDEL
Title or Position: LICENSED MENTAL HEALTH THERAPIST
Credential:
Phone: 515-707-7966