MEDICARE: ENLUMEN, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164353470
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENLUMEN, INC.

Provider Business Mailing Address
First Line	:	2154 125TH STREET
Second Line	:
City	:	FAIRFIELD
State	:	IA
Zip	:	52556
Country	:	US
Telephone Number	:	641-919-2474
Fax Number	:

Provider Business Practice Location Address
First Line	:	2154 125TH ST
Second Line	:
City	:	FAIRFIELD
State	:	IA
Zip	:	52556-8962
Country	:	US
Telephone Number	:	641-919-2474
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	MR. STEPHEN EARL PRETTYMAN
Credential	:	LISW
Telephone Number	:	641-919-2474

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ENLUMEN, INC. ” Practice Location

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