Provider Demographics
NPI:1104439215
Name:PEACE OF MIND COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:PEACE OF MIND COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:VANDENTOP
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:515-962-5561
Mailing Address - Street 1:117 N BUXTON ST
Mailing Address - Street 2:
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-2412
Mailing Address - Country:US
Mailing Address - Phone:515-962-5561
Mailing Address - Fax:844-588-5937
Practice Address - Street 1:117 N BUXTON ST
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-2412
Practice Address - Country:US
Practice Address - Phone:515-962-5561
Practice Address - Fax:544-588-5937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1184852873OtherWELLMARK BLUE CROSS BLUE SHIELD OF IOWA
IA1184852873Medicaid
IA1104439215OtherWELLMARK BLUE CROSS BLUE SHIELD OF IOWA