# HEADWATERS INTEGRATIVE CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942119573
- **Authorized official:** RUTH MCCLEERY (CEO)
- **Authorized official phone:** (712) 330-8090

## Contact information

- **Practice address:** 3008 18TH ST, SPIRIT LAKE, IA 51360-7471
- **Practice address phone:** (712) 330-8090
- **Mailing address:** 3008 18TH ST, SPIRIT LAKE, IA 51360-7471

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 09/01/2026
- **Last updated:** 09/01/2026