Healthcare Provider Details

I. General information

NPI: 1346298130
Provider Name (Legal Business Name): LYNNETTE SUE ASCHINGER LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 KENYON RD SUITE C
FORT DODGE IA
50501-5718
US

IV. Provider business mailing address

409 KENYON RD SUITE C
FORT DODGE IA
50501-5718
US

V. Phone/Fax

Practice location:
  • Phone: 515-573-3138
  • Fax: 515-573-3130
Mailing address:
  • Phone: 515-573-3138
  • Fax: 515-573-3130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number01675
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: