Healthcare Provider Details

I. General information

NPI: 1609794866
Provider Name (Legal Business Name): WENTWORTH COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

358 S 85TH ST
WEST DES MOINES IA
50266-8328
US

IV. Provider business mailing address

358 S 85TH ST
WEST DES MOINES IA
50266-8328
US

V. Phone/Fax

Practice location:
  • Phone: 515-217-1108
  • Fax:
Mailing address:
  • Phone: 515-217-1108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TRAVIS WENTWORTH
Title or Position: OWNER, THERAPIST
Credential: LISW, MACM
Phone: 515-217-1108