Healthcare Provider Details

I. General information

NPI: 1639644545
Provider Name (Legal Business Name): KAILEIGH SHATAI JOINER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2018
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2159 GRAND AVE
WEST DES MOINES IA
50265-4289
US

IV. Provider business mailing address

2159 GRAND AVE
WEST DES MOINES IA
50265-4289
US

V. Phone/Fax

Practice location:
  • Phone: 515-608-5420
  • Fax:
Mailing address:
  • Phone: 515-441-2247
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: