Healthcare Provider Details

I. General information

NPI: 1366364598
Provider Name (Legal Business Name): INNER BALANCE WELLNESS COLLECTIVE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 CEDAR CREST RDG STE 5
DUBUQUE IA
52003-6700
US

IV. Provider business mailing address

3100 CEDAR CREST RDG STE 5
DUBUQUE IA
52003-6700
US

V. Phone/Fax

Practice location:
  • Phone: 563-500-9974
  • Fax:
Mailing address:
  • Phone: 563-500-9974
  • 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: MEGHAN SMITH
Title or Position: OWNER/THERAPIST
Credential: LISW
Phone: 563-500-9974