Healthcare Provider Details

I. General information

NPI: 1346393246
Provider Name (Legal Business Name): LAURA M HILL LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 W CENTRAL PARK AVE
DAVENPORT IA
52804-1707
US

IV. Provider business mailing address

1441 W CENTRAL PARK AVE
DAVENPORT IA
52804-1707
US

V. Phone/Fax

Practice location:
  • Phone: 563-888-6275
  • Fax: 563-884-4638
Mailing address:
  • Phone: 563-888-6275
  • Fax: 563-884-4638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number02578
License Number StateIA

VII. Legacy identifiers

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

# 1
Identifier02578
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerLICENSE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: