Healthcare Provider Details

I. General information

NPI: 1457278228
Provider Name (Legal Business Name): GILMORE MENTAL HEALTH AND EVIDENCE BASED APPROACHES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 SHADY LANE DR
NORWALK IA
50211-9681
US

IV. Provider business mailing address

2505 SHADY LANE DR
NORWALK IA
50211-9681
US

V. Phone/Fax

Practice location:
  • Phone: 515-210-5494
  • Fax:
Mailing address:
  • Phone: 515-210-5494
  • 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: JENNIFER GILMORE
Title or Position: MENTAL HEALTH THERAPIST
Credential:
Phone: 515-210-5494