Healthcare Provider Details

I. General information

NPI: 1225842982
Provider Name (Legal Business Name): KAYLEE RAE CRANSTON LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLEE RAE PARRIS LISW

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 E MCKINLEY AVE
DES MOINES IA
50315-4362
US

IV. Provider business mailing address

1320 SE FLORENCE DR UNIT 10
WAUKEE IA
50263-8323
US

V. Phone/Fax

Practice location:
  • Phone: 515-346-9215
  • Fax: 515-282-8139
Mailing address:
  • Phone: 641-529-2919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number121230
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: