MEDICARE: FLOWSTATE HEALTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	101YM0800X	Mental Health Counselor
3	103TC0700X	Clinical Psychologist
4	1041C0700X	Clinical Social Worker
5	2084P0800X	Psychiatry Physician
6	251S00000X	Community/Behavioral Health Agency
7	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1114678141
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLOWSTATE HEALTH LLC

Provider Business Mailing Address
First Line	:	500 LOCUST ST
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50309-4104
Country	:	US
Telephone Number	:	515-805-0956
Fax Number	:

Provider Business Practice Location Address
First Line	:	500 LOCUST ST
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50309-4104
Country	:	US
Telephone Number	:	515-805-0956
Fax Number	:

Authorized Official
Title or Position	:	OWNER / CEO
Name	:	STEVEN SLYE
Credential	:
Telephone Number	:	515-805-0956

Provider Enumeration Date	:	01/11/2022
Last Update Date	:	07/05/2024

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