Healthcare Provider Details

I. General information

NPI: 1801620372
Provider Name (Legal Business Name): SARAH C KOENEN LISW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2024
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1603 22ND ST STE 203
WEST DES MOINES IA
50266-1410
US

IV. Provider business mailing address

1603 22ND ST STE 203
WEST DES MOINES IA
50266-1410
US

V. Phone/Fax

Practice location:
  • Phone: 515-599-6030
  • Fax:
Mailing address:
  • Phone: 515-599-6030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SARAH KOENEN
Title or Position: OWNER/THERAPIST
Credential: LISW
Phone: 515-599-6030