Healthcare Provider Details

I. General information

NPI: 1952210866
Provider Name (Legal Business Name): AMY ELLIOTT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7177 HICKMAN RD STE 9
URBANDALE IA
50322-4844
US

IV. Provider business mailing address

2508 46TH ST
DES MOINES IA
50310-3113
US

V. Phone/Fax

Practice location:
  • Phone: 515-238-1217
  • Fax:
Mailing address:
  • Phone:
  • 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: AMY ELLIOTT
Title or Position: MENTAL HEALTH THERAPIST
Credential: LISW
Phone: 515-238-1217