Healthcare Provider Details

I. General information

NPI: 1396671483
Provider Name (Legal Business Name): LC THERAPY COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2726 SHADY LANE DR
NORWALK IA
50211-9765
US

IV. Provider business mailing address

2726 SHADY LANE DR
NORWALK IA
50211-9765
US

V. Phone/Fax

Practice location:
  • Phone: 515-250-6567
  • Fax:
Mailing address:
  • Phone: 515-250-6567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: LANCE CARL CONNELLY
Title or Position: THERAPIST
Credential: LMHC
Phone: 515-250-6567