Provider Demographics
NPI:1225027238
Name:JOENS, RICHARD L (LISW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:L
Last Name:JOENS
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 INGERSOLL AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-3534
Mailing Address - Country:US
Mailing Address - Phone:515-279-6200
Mailing Address - Fax:515-279-4528
Practice Address - Street 1:3900 INGERSOLL AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-3534
Practice Address - Country:US
Practice Address - Phone:515-279-6200
Practice Address - Fax:515-279-4528
Is Sole Proprietor?:No
Enumeration Date:2005-10-21
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA010121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0249649Medicaid
IA42628OtherBLUE SHIELD
IA002440OtherVALUE OPTIONS
IA235144OtherMIDLANDS CHOICE
IAIA0103OtherDEERE
IA42628OtherFIRST ADMINISTRATORS
IA9P5081OtherEMPIRE BLUE SHIELD
IA9P5081OtherEMPIRE BLUE SHIELD