MEDICARE: MRS. JESSICA BLAKE 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
1	1041C0700X	Clinical Social Worker	06700	IA

General Provider Information

NPI Number	:	1013142991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JESSICA BLAKE LISW

Provider Business Mailing Address
First Line	:	3100 E AVE NW
Second Line	:	SUITE 101
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52405-2962
Country	:	US
Telephone Number	:	319-396-1066
Fax Number	:

Provider Business Practice Location Address
First Line	:	3100 E AVE NW
Second Line	:	SUITE 101
City	:	CEDAR RAPIDS
State	:	IA
Zip	:	52405-2962
Country	:	US
Telephone Number	:	319-396-1066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2009
Last Update Date	:	05/21/2009

Similar Medicare Providers

1851392880 — MR. THOMAS J KREMER LISW
Practice Location Address:

3100 E AVE NW , STE 101
CEDAR RAPIDS, IA
52405-2962

Practice Phone: 319-396-1066
Practice Fax:

1982605762 — DR. JEFFREY D WILHARM MD
Practice Location Address:

3100 E AVE NW , SUITE 101
CEDAR RAPIDS, IA
52405-2962

Practice Phone: 319-396-1066
Practice Fax: 319-396-8779

1144221490 — MS. TRINA REITER USW
Practice Location Address:

3100 E AVE NW , SUITE 101
CEDAR RAPIDS, IA
52405-2962

Practice Phone: 319-396-3110
Practice Fax: 319-396-8779

1962403220 — MR. EDGAR J SIGUENZA LISW
Practice Location Address:

3100 E AVE NW , STE 101
CEDAR RAPIDS, IA
52405-2962

Practice Phone: 319-396-3110
Practice Fax: 319-396-8779

1154495547 — PATRICIA BOWEN LISW
Practice Location Address:

3100 E AVE NW
CEDAR RAPIDS, IA
52405-2962

Practice Phone: 319-261-0576
Practice Fax:

1124419197 — MRS. NICOLE BRIGHTON MA, TLMFT
Practice Location Address:

3100 E AVE NW
CEDAR RAPIDS, IA
52405-2962

Practice Phone: 800-531-4236
Practice Fax: 319-483-6661

Directions to “ MRS. JESSICA BLAKE LISW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.