Provider Demographics
NPI:1063520872
Name:RINEHART, JUDITH K (MSW)
Entity type:Individual
Prefix:MR
First Name:JUDITH
Middle Name:K
Last Name:RINEHART
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 OFFICE PARK RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2505
Mailing Address - Country:US
Mailing Address - Phone:515-288-5570
Mailing Address - Fax:515-440-3388
Practice Address - Street 1:939 OFFICE PARK RD
Practice Address - Street 2:STE 200
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2505
Practice Address - Country:US
Practice Address - Phone:515-288-5570
Practice Address - Fax:515-440-3388
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000011041C0700X
IA064106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4210538445026506OtherTRIWEST
IA01431OtherWELLMARK BLUE CROSS OF IA
IAI6720Medicare ID - Type Unspecified