Healthcare Provider Details

I. General information

NPI: 1073498465
Provider Name (Legal Business Name): JAYDEN MARCELLA LAMMERS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 NW 114TH ST
CLIVE IA
50325-7039
US

IV. Provider business mailing address

401 BRAEBURN DR
NORWALK IA
50211-2210
US

V. Phone/Fax

Practice location:
  • Phone: 515-553-6184
  • Fax:
Mailing address:
  • Phone: 515-402-2610
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number132245
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: