Healthcare Provider Details

I. General information

NPI: 1013846351
Provider Name (Legal Business Name): MELISSA M CANO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1454 30TH ST STE 107
WEST DES MOINES IA
50266-1311
US

IV. Provider business mailing address

1454 30TH ST STE 107
WEST DES MOINES IA
50266-1311
US

V. Phone/Fax

Practice location:
  • Phone: 319-800-5564
  • Fax: 515-207-1485
Mailing address:
  • Phone: 319-800-5564
  • Fax: 515-207-1485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number138524
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: