Healthcare Provider Details

I. General information

NPI: 1801790720
Provider Name (Legal Business Name): DESIREE RUTH LABLANC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3102 INGERSOLL AVE
DES MOINES IA
50312-3910
US

IV. Provider business mailing address

5120 SYCAMORE DR
PLEASANT HILL IA
50327-1972
US

V. Phone/Fax

Practice location:
  • Phone: 515-333-1978
  • Fax:
Mailing address:
  • Phone: 515-491-2810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number140787
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: