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Individual

MICHAEL DAVID STATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
LMHC

Contact information

Practice address
1111 UNIVERSITY AVE, DES MOINES, IA 50314-2329
(515) 288-1981
Mailing address
1111 UNIVERSITY AVE, DES MOINES, IA 50314-2329
(515) 288-1981
(312) 943-6530

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
108844
IA
101YP2500X
Professional Counselor
178.014149
IL

Other

Enumeration date
09/30/2019
Last updated
09/13/2022
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