MEDICARE: KAMI SUE WINTHER MS, TLMHC

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	085949	IA

General Provider Information

NPI Number	:	1356840565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMI SUE WINTHER MS, TLMHC

Provider Business Mailing Address
First Line	:	722 WASHINGTON ST
Second Line	:
City	:	FONTANELLE
State	:	IA
Zip	:	50846-8099
Country	:	US
Telephone Number	:	515-380-2121
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 VALLEY WEST DR STE 302
Second Line	:
City	:	WEST DES MOINES
State	:	IA
Zip	:	50266-1904
Country	:	US
Telephone Number	:	515-267-1340
Fax Number	:	515-267-1355

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

Provider Enumeration Date	:	02/03/2018
Last Update Date	:	02/03/2018

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