Stephanie Crandall, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

096779 Issued in IA

Practice address

9550 White Oak LN Ste 200
Johnston, IA 50131-2267

Phone

(515) 259-8110

NPI assigned

Aug 23, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Stephanie Petchulat Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Creative Community Options Inc

  dba Candeo

  • Day Training/Habilitation Specialist
  • Johnston, IA
  • NPI 1023149267
  NPD
• The Easter Seal Society of Iowa, Inc.

  dba Easter Seals Iowa

  • Voluntary or Charitable Agency
  • Des Moines, IA
  • NPI 1295739951
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566518400000",
    "number": "1215584289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 WHITE OAK LN STE 200",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312267",
            "telephone_number": "515-259-8110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 WHITE OAK LN STE 200",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312267",
            "telephone_number": "515-259-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "STEPHANIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "096779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "PETCHULAT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Corbridge, BCBA, LBA
• Counseling Insights, LLC
• Courage Counseling Center, PLLC
• Elizabeth Ashley Coyle
• Emilie Cramond, PT, DPT
• Creative Community Options Inc (Candeo)
• Natalie Cremer
• Jordan Elizabeth Cronbaugh-Jones, LMHC
• Rebecca Cummings, MA, CCC-SLP
• Stefanie Cunard, PT

• Clinical Social Worker in Johnston, IA
• Providers in Johnston, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.