Healthcare Provider Details

I. General information

NPI: 1730143546
Provider Name (Legal Business Name): DOROTHY WESTIN-YOCKEY LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

4301 SERGEANT RD SUITE 203
SIOUX CITY IA
51106-4726
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 712-276-9000
  • Fax: 712-276-4917
Mailing address:
  • Phone: 515-573-3138
  • Fax: 515-573-3130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1540
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number00817
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number808
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: