Healthcare Provider Details

I. General information

NPI: 1033898515
Provider Name (Legal Business Name): JENNIFER LYNN ROBERTS LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER LYNN MCCLAFLIN

II. Dates (important events)

Enumeration Date: 07/13/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2708 GRAND AVE
DES MOINES IA
50312-5218
US

IV. Provider business mailing address

2708 GRAND AVE
DES MOINES IA
50312-5218
US

V. Phone/Fax

Practice location:
  • Phone: 515-778-4592
  • Fax:
Mailing address:
  • Phone: 515-778-4592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number112747
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: