Healthcare Provider Details

I. General information

NPI: 1154233997
Provider Name (Legal Business Name): KAMEESHA CREIGHTON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 BEECH ST
WATERLOO IA
50703-3317
US

IV. Provider business mailing address

306 CLAY ST
WATERLOO IA
50703-3827
US

V. Phone/Fax

Practice location:
  • Phone: 319-939-1299
  • Fax:
Mailing address:
  • Phone: 319-939-1299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number137841
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: