Healthcare Provider Details

I. General information

NPI: 1477953628
Provider Name (Legal Business Name): CORTNEY LYNN ALBER LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2014
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 1ST ST E STE A
INDEPENDENCE IA
50644-2815
US

IV. Provider business mailing address

324 1ST ST E STE A
INDEPENDENCE IA
50644-2815
US

V. Phone/Fax

Practice location:
  • Phone: 319-849-5185
  • Fax:
Mailing address:
  • Phone: 319-849-5185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number072774
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: