Organization
INTEGRATIVE COUNSELING PRACTICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA LEA STORK LMHC (MEMBER)
(712) 790-9318
Entity
Organization
Contact information
Practice address
1728 CENTRAL AVE STE 10, FORT DODGE, IA 50501-4200
(712) 790-9318
(515) 598-8545
Mailing address
3662 GARBER AVE, LAKE CITY, IA 51449-7554
(712) 790-9318
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/06/2020
Last updated
08/31/2020
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