Healthcare Provider Details

I. General information

NPI: 1124306709
Provider Name (Legal Business Name): KATIE RAYE CABRERIZA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2011
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4217 UNIVERSITY AVE
DES MOINES IA
50311-3421
US

IV. Provider business mailing address

3510 50TH ST
DES MOINES IA
50310-2648
US

V. Phone/Fax

Practice location:
  • Phone: 515-349-7160
  • Fax:
Mailing address:
  • Phone: 515-349-7160
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number001429
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: