Healthcare Provider Details

I. General information

NPI: 1710892401
Provider Name (Legal Business Name): MECOLLECTIVE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3008 DRUID HILL DR
DES MOINES IA
50315-2119
US

IV. Provider business mailing address

3008 DRUID HILL DR
DES MOINES IA
50315-2119
US

V. Phone/Fax

Practice location:
  • Phone: 641-895-3488
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MRS. JOHANNA LYN GRENKO
Title or Position: THERAPIST
Credential: LISW
Phone: 641-895-3488