=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801750823
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PURE LIFE COUNSELING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/13/2025
-----------------------------------------------------
Last Update Date | 12/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1680 SW ANKENY RD APT 7A
-----------------------------------------------------
City | ANKENY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50023-8387
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-650-9861
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2602 SW 19TH ST
-----------------------------------------------------
City | ANKENY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50023-7144
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 515-650-9861
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HANNAH OVERSTAKE
-----------------------------------------------------
Credential | LISW
-----------------------------------------------------
Telephone | 515-650-9861
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------