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NPI Code Detail

MEDICARE: CHRISTOPHER M LOECKLE LISW

MEDICARE: CHRISTOPHER M LOECKLE LISW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor006933IA

General Provider Information

NPI Number : 1003051376
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER M LOECKLE LISW
Provider Business Mailing Address
First Line : 1530 SHERIDAN AVE
Second Line :
City : IOWA CITY
State : IA
Zip : 52240-6259
Country : US
Telephone Number : 319-541-5859
Fax Number :
Provider Business Practice Location Address
First Line : 221 E COLLEGE ST STE 211
Second Line :
City : IOWA CITY
State : IA
Zip : 52240-1759
Country : US
Telephone Number : 319-541-5859
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2008
Last Update Date : 01/31/2014

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Directions to “ CHRISTOPHER M LOECKLE LISW” Practice Location

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