Healthcare Provider Details

I. General information

NPI: 1710834775
Provider Name (Legal Business Name): INTEGRATIVE MENTAL HEALTH OF THE MIDWEST, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 19TH ST FEJERAN WELLNESS
DES MOINES IA
50314-1112
US

IV. Provider business mailing address

800 19TH ST FEJERAN WELLNESS
DES MOINES IA
50314-1112
US

V. Phone/Fax

Practice location:
  • Phone: 515-605-0704
  • Fax: 515-644-5503
Mailing address:
  • Phone: 515-605-0704
  • Fax: 515-644-5503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIELLE FITCH
Title or Position: OWNER/PROVIDER
Credential: DNP, PMHNP-BC
Phone: 515-605-0704