Provider Demographics
NPI:1255676607
Name:PRATT, MAKAELA MARIE (LISW)
Entity Type:Individual
Prefix:
First Name:MAKAELA
Middle Name:MARIE
Last Name:PRATT
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 WESTOWN PKWY STE 240
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-7711
Mailing Address - Country:US
Mailing Address - Phone:515-339-2566
Mailing Address - Fax:
Practice Address - Street 1:6600 WESTOWN PKWY STE 240
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-7714
Practice Address - Country:US
Practice Address - Phone:515-401-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-11
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0079681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical