Healthcare Provider Details

I. General information

NPI: 1205763703
Provider Name (Legal Business Name): ALYSSA M HUGHES LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 E SAN MARNAN DR
WATERLOO IA
50702-5829
US

IV. Provider business mailing address

301 2ND AVE SE
DYERSVILLE IA
52040-1802
US

V. Phone/Fax

Practice location:
  • Phone: 563-500-9993
  • Fax:
Mailing address:
  • Phone: 563-500-9993
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number118395
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: