Provider Demographics
NPI:1013376227
Name:BRASS, CALLIE (LMHC)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:
Last Name:BRASS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 E. COURT AVE.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309
Mailing Address - Country:US
Mailing Address - Phone:515-243-3525
Mailing Address - Fax:
Practice Address - Street 1:600 E COURT AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2058
Practice Address - Country:US
Practice Address - Phone:515-243-3525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-16
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080221101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health