Provider Demographics
NPI:1215919725
Name:AHRENS, KAREN RAE (PSYD LP)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:RAE
Last Name:AHRENS
Suffix:
Gender:F
Credentials:PSYD LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 VALLEY WEST DR
Mailing Address - Street 2:SUITE 707
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1908
Mailing Address - Country:US
Mailing Address - Phone:515-222-1999
Mailing Address - Fax:515-224-3949
Practice Address - Street 1:1200 VALLEY WEST DR
Practice Address - Street 2:SUITE 707
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1908
Practice Address - Country:US
Practice Address - Phone:515-222-1999
Practice Address - Fax:515-224-3949
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1009103TC0700X
IA00483103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
P67575Medicare UPIN
IAI19052Medicare ID - Type Unspecified