Healthcare Provider Details

I. General information

NPI: 1548340854
Provider Name (Legal Business Name): DEBRA ANN ESTES LISW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 S GRAND AVE
SPENCER IA
51301-5749
US

IV. Provider business mailing address

4860 220TH AVE
SIOUX RAPIDS IA
50585-7500
US

V. Phone/Fax

Practice location:
  • Phone: 712-262-6111
  • Fax:
Mailing address:
  • Phone: 319-240-4093
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number01433
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: