Healthcare Provider Details

I. General information

NPI: 1033514948
Provider Name (Legal Business Name): LANCE ROORDA LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2014
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

616 FRANKLIN PL
PELLA IA
50219-1641
US

IV. Provider business mailing address

2250 DAVIS DR
LEIGHTON IA
50143-8041
US

V. Phone/Fax

Practice location:
  • Phone: 641-658-9311
  • Fax: 641-658-9105
Mailing address:
  • Phone: 515-988-8217
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number073001
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: