Provider Demographics
NPI:1598010613
Name:JESSEN, ANNE ELIZABETH (LMHC, NCC, CADC)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:ELIZABETH
Last Name:JESSEN
Suffix:
Gender:F
Credentials:LMHC, NCC, CADC
Other - Prefix:MS
Other - First Name:ANNIE
Other - Middle Name:ELIZABETH
Other - Last Name:JESSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC, NCC, CADC
Mailing Address - Street 1:4908 FRANKLIN AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-1901
Mailing Address - Country:US
Mailing Address - Phone:515-280-3860
Mailing Address - Fax:515-883-2683
Practice Address - Street 1:4908 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-1901
Practice Address - Country:US
Practice Address - Phone:515-280-3860
Practice Address - Fax:515-883-2683
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-15
Last Update Date:2012-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA09056101YA0400X
IA001272101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health