Healthcare Provider Details

I. General information

NPI: 1760085252
Provider Name (Legal Business Name): YOLANDA DENISE LOUIS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2020
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 29TH STREET DR SE APT 13
CEDAR RAPIDS IA
52403-1477
US

IV. Provider business mailing address

426 29TH STREET DR SE APT 13
CEDAR RAPIDS IA
52403-1477
US

V. Phone/Fax

Practice location:
  • Phone: 319-208-3409
  • Fax:
Mailing address:
  • Phone: 319-338-0581
  • Fax: 319-339-7147

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number124931
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number149.017499
License Number StateIL

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: