Provider Demographics
NPI:1578676128
Name:KROM, DARLA RAE (MSW, LISW)
Entity type:Individual
Prefix:MS
First Name:DARLA
Middle Name:RAE
Last Name:KROM
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1345 SW PARK SQUARE DR STE 206
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2687
Mailing Address - Country:US
Mailing Address - Phone:515-329-7735
Mailing Address - Fax:515-608-4580
Practice Address - Street 1:1345 SW PARK SQUARE DR STE 206
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2687
Practice Address - Country:US
Practice Address - Phone:515-329-7735
Practice Address - Fax:515-608-4580
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA062281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0249649Medicaid
IA0249649Medicaid