Provider Demographics
NPI:1215701040
Name:BROWN-COFFMAN, JESSICA ANN (LMSW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:ANN
Last Name:BROWN-COFFMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 49TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-2540
Mailing Address - Country:US
Mailing Address - Phone:563-451-9222
Mailing Address - Fax:
Practice Address - Street 1:2417 49TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-2540
Practice Address - Country:US
Practice Address - Phone:563-451-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-13
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1078471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical