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General NPI Number Information
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NPI Number | 1255644084
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Entity Type | Organization
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Legal Business Name | ALLIANCE MENTAL HEALTH SERVICES, LLC
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Dates
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Enumeration Date | 07/21/2010
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Last Update Date | 07/21/2010
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Provider Practice Location Address
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Address Line | 1448 19TH PL
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City | WEST DES MOINES
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State | IA
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Zip | 50265-1635
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Country | US
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Telephone | 515-720-4703
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Fax |
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Provider Business Mailing Address
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Address Line | 1448 19TH PL
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City | WEST DES MOINES
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State | IA
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Zip | 50265-1635
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Country | US
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Telephone | 515-720-4703
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Fax |
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Authorized Official
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Title or Position | PARTNER/CLINICAL DIRECTOR
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Name | MELISSA JUNE CRIBARI
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Credential | LMHC, CADC
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Telephone | 515-720-4703
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 06140
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 001109
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License Number State | IA
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