Provider Demographics
NPI:1568698769
Name:STROSAHL, KASEY JEAN (DO)
Entity Type:Individual
Prefix:
First Name:KASEY
Middle Name:JEAN
Last Name:STROSAHL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KASEY
Other - Middle Name:JEAN
Other - Last Name:MATTHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1111 DUFF AVE
Mailing Address - Street 2:BEHAVIORAL HEALTH
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-5745
Mailing Address - Country:US
Mailing Address - Phone:515-239-2682
Mailing Address - Fax:
Practice Address - Street 1:1111 DUFF AVE
Practice Address - Street 2:BEHAVIORAL HEALTH
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-5745
Practice Address - Country:US
Practice Address - Phone:515-239-2682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-02
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA42172084P0800X
IAR-86822084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1600304Medicaid
IA1600304Medicaid