Basic Information
Provider Information
NPI: 1154994754
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHEEKS
FirstName: HILARY
MiddleName: ANNE
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6200 AURORA AVE STE 401E
Address2:  
City: URBANDALE
State: IA
PostalCode: 503222866
CountryCode: US
TelephoneNumber: 5153310303
FaxNumber:  
Practice Location
Address1: 6200 AURORA AVE STE 401E
Address2:  
City: URBANDALE
State: IA
PostalCode: 503222866
CountryCode: US
TelephoneNumber: 5153310303
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/21/2021
LastUpdateDate: 07/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X109117IAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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