Healthcare Provider Details

I. General information

NPI: 1821951443
Provider Name (Legal Business Name): WINGS OF CHANGE COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4949 WESTOWN PKWY STE 100
WEST DES MOINES IA
50266-6704
US

IV. Provider business mailing address

4949 WESTOWN PKWY STE 100
WEST DES MOINES IA
50266-6704
US

V. Phone/Fax

Practice location:
  • Phone: 515-373-2349
  • Fax: 515-870-2964
Mailing address:
  • Phone: 515-373-2349
  • Fax: 515-870-2964

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: AMY DEMONEY
Title or Position: PROVIDER
Credential: LISW
Phone: 515-373-2349