Healthcare Provider Details

I. General information

NPI: 1619824497
Provider Name (Legal Business Name): RACHAEL E RAGAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3623 E 42ND ST
DES MOINES IA
50317-8101
US

IV. Provider business mailing address

3623 E 42ND ST
DES MOINES IA
50317-8101
US

V. Phone/Fax

Practice location:
  • Phone: 515-443-1251
  • Fax:
Mailing address:
  • Phone: 515-443-1251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: