Provider Demographics
NPI:1023328150
Name:KIER, SHAWNA RENAE (MA, QMHP, TLMHC)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:RENAE
Last Name:KIER
Suffix:
Gender:F
Credentials:MA, QMHP, TLMHC
Other - Prefix:
Other - First Name:SHAWNA
Other - Middle Name:RENAE
Other - Last Name:TUFFIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA
Mailing Address - Street 1:PO BOX 1628
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-1628
Mailing Address - Country:US
Mailing Address - Phone:515-233-3141
Mailing Address - Fax:
Practice Address - Street 1:125 S 3RD ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-7042
Practice Address - Country:US
Practice Address - Phone:515-233-3141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2015-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
IA079281101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator