Provider Demographics
NPI:1720049307
Name:CLAUSEN, JESSICA S (LISW)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:S
Last Name:CLAUSEN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 S ANKENY BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9417
Mailing Address - Country:US
Mailing Address - Phone:515-989-8266
Mailing Address - Fax:515-686-8003
Practice Address - Street 1:2825 S ANKENY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9417
Practice Address - Country:US
Practice Address - Phone:515-989-8266
Practice Address - Fax:515-686-8003
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-31
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA061931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA05688OtherWELLMARK
IAI16727Medicare PIN
IAQ60034Medicare UPIN