Healthcare Provider Details

I. General information

NPI: 1366234395
Provider Name (Legal Business Name): GOOD NEWS COUNSELING PROFESSIONAL LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2025
Last Update Date: 05/17/2025
Certification Date: 05/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 LIBERTY ST STE 133
PELLA IA
50219-1776
US

IV. Provider business mailing address

604 LIBERTY ST STE 133
PELLA IA
50219-1776
US

V. Phone/Fax

Practice location:
  • Phone: 641-230-9093
  • Fax:
Mailing address:
  • Phone: 641-230-9093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: STALIN GEORGE
Title or Position: OWNER/THERAPIST
Credential: L.M.H.C
Phone: 641-230-9093