Healthcare Provider Details

I. General information

NPI: 1508140039
Provider Name (Legal Business Name): KATHY ANN DEARCHS LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHY ANN THILGES LMSW

II. Dates (important events)

Enumeration Date: 10/03/2011
Last Update Date: 09/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S PHILLIPS ST
ALGONA IA
50511-3649
US

IV. Provider business mailing address

1515 S PHILLIPS ST
ALGONA IA
50511-3649
US

V. Phone/Fax

Practice location:
  • Phone: 515-295-4430
  • Fax: 515-295-5256
Mailing address:
  • Phone: 515-295-4430
  • Fax: 515-295-5256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number8203
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number007950
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: