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General NPI Number Information
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NPI Number | 1730042219
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Entity Type | Organization
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Legal Business Name | WISDOM FROM WOUNDS, LLC
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 1045 76TH ST UNIT 3025
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City | WEST DES MOINES
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State | IA
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Zip | 50266-5913
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Country | US
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Telephone | 515-337-9309
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Fax |
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Provider Business Mailing Address
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Address Line | 1045 76TH ST UNIT 3025
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City | WEST DES MOINES
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State | IA
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Zip | 50266-5913
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Country | US
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Telephone | 515-337-9309
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH COUNSELOR
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Name | SAMANTHA ADELL RIVES
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Credential | LMHC
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Telephone | 515-337-9309
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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