MEDICARE: EARTHWORKS WELLNESS CENTER LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1346102431
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EARTHWORKS WELLNESS CENTER LLC

Provider Business Mailing Address
First Line	:	1486 S 1ST AVE STE A
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6072
Country	:	US
Telephone Number	:	319-406-2388
Fax Number	:

Provider Business Practice Location Address
First Line	:	1486 S 1ST AVE STE A
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6072
Country	:	US
Telephone Number	:	319-406-2388
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	MELISSA MORELAND
Credential	:	LMHC
Telephone Number	:	319-406-2388

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	11/26/2025

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