Provider Demographics
NPI:1194575845
Name:FLOURISH COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:FLOURISH COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:954-298-2050
Mailing Address - Street 1:1607 NE SHILOH CT
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50021-7771
Mailing Address - Country:US
Mailing Address - Phone:954-298-2050
Mailing Address - Fax:
Practice Address - Street 1:950 OFFICE PARK RD STE 131
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2586
Practice Address - Country:US
Practice Address - Phone:954-298-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)