Provider Demographics
NPI:1376252064
Name:RANSOM, ABIGAIL (MA, LMHC-T, ATR-P)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:RANSOM
Suffix:
Gender:F
Credentials:MA, LMHC-T, ATR-P
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:GRYBOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:501 SW ANKENY RD
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-9702
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:501 SW ANKENY RD
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-9702
Practice Address - Country:US
Practice Address - Phone:515-289-2272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-21
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
22383221700000X
IA117095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist