Provider Demographics
NPI:1043867278
Name:MEISENHEIMER, BREANNE (LISW)
Entity Type:Individual
Prefix:
First Name:BREANNE
Middle Name:
Last Name:MEISENHEIMER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:BREANNE
Other - Middle Name:
Other - Last Name:CHAPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:808 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1307
Mailing Address - Country:US
Mailing Address - Phone:515-244-2267
Mailing Address - Fax:
Practice Address - Street 1:808 5TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1307
Practice Address - Country:US
Practice Address - Phone:515-244-2267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-22
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0955461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical