Healthcare Provider Details

I. General information

NPI: 1194638973
Provider Name (Legal Business Name): ANNA NIKOLE HUMMEL TLMHC
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

521 INDUSTRIAL AVE
GRINNELL IA
50112-8159
US

IV. Provider business mailing address

PO BOX 542
KILLDUFF IA
50137-0542
US

V. Phone/Fax

Practice location:
  • Phone: 641-323-2729
  • Fax:
Mailing address:
  • Phone: 515-975-5656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number138792
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: