Provider Demographics
NPI:1730733205
Name:FIALA, ERIN ALLYN (LMHC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:ALLYN
Last Name:FIALA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5619 NW 86TH ST STE 500
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-2955
Mailing Address - Country:US
Mailing Address - Phone:515-214-6373
Mailing Address - Fax:
Practice Address - Street 1:5619 NW 86TH ST STE 500
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2955
Practice Address - Country:US
Practice Address - Phone:515-214-6373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-01
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA095769101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health