Basic Information
| Provider Information | |||||||||
| NPI: | 1669678926 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OBERHELMAN | ||||||||
| FirstName: | CALISTA | ||||||||
| MiddleName: | STEPHANIE | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 CENTER ST. | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503091004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152435181 | ||||||||
| FaxNumber: | 5152432760 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 CENTER ST. | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503091004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5152435181 | ||||||||
| FaxNumber: | 5152432760 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/25/2007 | ||||||||
| LastUpdateDate: | 01/13/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | 006863 | IA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.