Provider Demographics
NPI:1093265761
Name:BARBARA PETERSEN-FOX, LISW, LLC
Entity Type:Organization
Organization Name:BARBARA PETERSEN-FOX, LISW, LLC
Other - Org Name:CLARITY COUNSELING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEN-FOX
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-250-7380
Mailing Address - Street 1:1200 VALLEY WEST DR STE 702
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1907
Mailing Address - Country:US
Mailing Address - Phone:515-225-1940
Mailing Address - Fax:
Practice Address - Street 1:1200 VALLEY WEST DR STE 702
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1907
Practice Address - Country:US
Practice Address - Phone:515-225-1940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01826251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health