Healthcare Provider Details

I. General information

NPI: 1316850860
Provider Name (Legal Business Name): TAYLOR TUTHILL MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 AURORA AVE
URBANDALE IA
50322-2800
US

IV. Provider business mailing address

4604 SAWYERS DR
DES MOINES IA
50310-2924
US

V. Phone/Fax

Practice location:
  • Phone: 515-274-9607
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number138945
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: