Healthcare Provider Details

I. General information

NPI: 1619490059
Provider Name (Legal Business Name): JAMIE MAE ALLEN B.A. CADC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2017
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E EUCLID AVE STE 157
DES MOINES IA
50313-4583
US

IV. Provider business mailing address

100 E EUCLID AVE STE 157
DES MOINES IA
50313-4583
US

V. Phone/Fax

Practice location:
  • Phone: 515-381-3001
  • Fax: 515-381-3001
Mailing address:
  • Phone: 515-381-3001
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number090817
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9347
License Number StateSC
# 4
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: