Healthcare Provider Details

I. General information

NPI: 1538023197
Provider Name (Legal Business Name): AMY TIEFENTHALER, 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

1603 22ND ST STE 203
WEST DES MOINES IA
50266-1410
US

IV. Provider business mailing address

1603 22ND ST STE 203
WEST DES MOINES IA
50266-1410
US

V. Phone/Fax

Practice location:
  • Phone: 515-200-3456
  • Fax: 515-217-4820
Mailing address:
  • Phone: 515-200-3456
  • Fax: 515-217-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: AMY TIEFENTHALER
Title or Position: MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 515-200-3456