Provider Demographics
NPI:1972604395
Name:HEMESATH, CRYSTAL (LMFT, LMHC, CADC)
Entity type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:
Last Name:HEMESATH
Suffix:
Gender:F
Credentials:LMFT, LMHC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 78TH PL
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2640
Mailing Address - Country:US
Mailing Address - Phone:515-556-3668
Mailing Address - Fax:515-440-0458
Practice Address - Street 1:775 78TH PL
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-2640
Practice Address - Country:US
Practice Address - Phone:515-556-3668
Practice Address - Fax:515-440-0458
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00712101YM0800X
IA00202106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist