Provider Demographics
NPI:1295547362
Name:RAHNAVARDI, JOANNA (MAE, LMHC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:RAHNAVARDI
Suffix:
Gender:F
Credentials:MAE, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-1321
Mailing Address - Country:US
Mailing Address - Phone:319-349-5764
Mailing Address - Fax:
Practice Address - Street 1:303 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-1321
Practice Address - Country:US
Practice Address - Phone:319-349-5764
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA129190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health