Provider Demographics
NPI:1346972874
Name:ACHENBACH, JAYDE D (CADC)
Entity Type:Individual
Prefix:
First Name:JAYDE
Middle Name:D
Last Name:ACHENBACH
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:JAYDE
Other - Middle Name:D
Other - Last Name:SLEETH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CADC
Mailing Address - Street 1:1300 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2306
Mailing Address - Country:US
Mailing Address - Phone:515-280-3860
Mailing Address - Fax:
Practice Address - Street 1:1300 WOODLAND AVE
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2306
Practice Address - Country:US
Practice Address - Phone:515-280-3860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-24
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)