Individual provider Active NPI

Blaine Conrad, LISW

  • Clinical Social Worker
  • West Des Moines, IA
National Provider Identifier
1336518059
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
076934 Issued in IA
Practice address
1200 Valley West Dr Ste 704
West Des Moines, IA 50266-1907
Phone
(515) 732-9599
Fax
(515) 418-0890
NPI assigned
Sep 23, 2015
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 076934 IA Primary

Addresses

Primary practice location

1200 Valley West Dr Ste 704
West Des Moines, IA 50266-1907

Mailing address

1200 Valley West Dr Ste 704
West Des Moines, IA 50266-1907
Phone (515) 732-9599

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Blaine@helpingheartstherapyservices.com Direct Helping Hearts Therapy Services LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
076934IAMDClinical Social Worker

Interoperability endpoints

  • Direct secure messaging: blaine@helpingheartstherapyservices.com

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1336518059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 VALLEY WEST DR STE 704",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661907",
            "telephone_number": "515-732-9599",
            "fax_number": "515-418-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 VALLEY WEST DR STE 704",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502661907",
            "telephone_number": "515-732-9599",
            "fax_number": "515-418-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "BLAINE",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "076934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Blaine@helpingheartstherapyservices.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Helping Hearts Therapy Services LLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PDF",
            "address_1": "1200 Valley West Dr Ste 704",
            "city": "West Des Moines",
            "state": "IA",
            "country_code": "US",
            "postal_code": "502661907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2021; 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.