Provider Demographics
NPI:1679066039
Name:CONRAD, ALLISON N (LMSW)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:N
Last Name:CONRAD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALLI
Other - Middle Name:
Other - Last Name:CONRAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:918 SE 11TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-5324
Mailing Address - Country:US
Mailing Address - Phone:515-282-9377
Mailing Address - Fax:515-282-6162
Practice Address - Street 1:918 SE 11TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-5324
Practice Address - Country:US
Practice Address - Phone:515-282-9377
Practice Address - Fax:515-282-6162
Is Sole Proprietor?:No
Enumeration Date:2018-06-11
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA091023104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker