Healthcare Provider Details

I. General information

NPI: 1629470034
Provider Name (Legal Business Name): ALLISON JEAN SYKES LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 10/01/2024
Certification Date: 10/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

403 1ST ST SE
BELMOND IA
50421-1201
US

IV. Provider business mailing address

1316 S MAIN ST
CLARION IA
50525-2019
US

V. Phone/Fax

Practice location:
  • Phone: 641-444-3500
  • Fax: 641-444-5688
Mailing address:
  • Phone: 515-532-2811
  • Fax: 319-343-1161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number105742
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number105742
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: