MEDICARE: ERIN BONSTEAD TCADC

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	084400	IA

General Provider Information

NPI Number	:	1609316819
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN BONSTEAD TCADC

Provider Business Mailing Address
First Line	:	500 SW 7TH ST STE 304
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50309-4583
Country	:	US
Telephone Number	:	712-422-3142
Fax Number	:	833-616-4714

Provider Business Practice Location Address
First Line	:	361 MUIRFIELD CT
Second Line	:
City	:	DAKOTA DUNES
State	:	SD
Zip	:	57049-5117
Country	:	US
Telephone Number	:	712-422-3142
Fax Number	:	833-616-4714

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

Provider Enumeration Date	:	03/07/2017
Last Update Date	:	01/28/2026

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