MEDICARE: SHERRY L FISCELLA LMHC

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	124132	IA

General Provider Information

NPI Number	:	1306792502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRY L FISCELLA LMHC

Provider Business Mailing Address
First Line	:	6165 NW 86TH ST
Second Line	:
City	:	JOHNSTON
State	:	IA
Zip	:	50131-2240
Country	:	US
Telephone Number	:	515-850-0304
Fax Number	:

Provider Business Practice Location Address
First Line	:	3250 SE SOTERIA AVE
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50265
Country	:	US
Telephone Number	:	515-850-0304
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2026
Last Update Date	:	03/09/2026

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