| Stevie Van Housen Lisw | |
|
2107 10th St Coralville IA 52241-1325 | |
| (319) 351-4805 | |
| Not Available |
| Full Name | Stevie Van Housen Lisw |
|---|---|
| Speciality | Social Worker |
| Location | 2107 10th St, Coralville, Iowa |
| Authorized Official Name and Position | Stephanie Van Housen (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 3193514805 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stevie Van Housen Lisw 2107 10th St Coralville IA 52241-1325 Ph: (319) 351-4805 | Stevie Van Housen Lisw 2107 10th St Coralville IA 52241-1325 Ph: (319) 351-4805 |
| NPI Number | 1518694330 |
|---|---|
| Provider Enumeration Date | 08/02/2022 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Medicare PECOS PAC ID | 7214310770 |
|---|---|
| Medicare Enrollment ID | O20220816001256 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518694330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Lynn Van Housen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518555150 PECOS PAC ID: 7911315254 Enrollment ID: I20210426001720 |
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