Healthcare Provider Details

I. General information

NPI: 1215464169
Provider Name (Legal Business Name): LINDSAY MEADE HOPP LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDSAY MARIE MEADE LISW

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 09/11/2023
Certification Date: 09/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 BLAIRS FERRY RD UNIT A
HIAWATHA IA
52233-1900
US

IV. Provider business mailing address

1061 COURT AVE
MARENGO IA
52301-1439
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-6575
  • Fax:
Mailing address:
  • Phone: 319-361-6529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number086289
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: