MEDICARE: ASHLEY LEE 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	007261	IA

General Provider Information

NPI Number	:	1043598790
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LEE LISW

Provider Business Mailing Address
First Line	:	12662 HIGHWAY 61
Second Line	:
City	:	BURLINGTON
State	:	IA
Zip	:	52601-8801
Country	:	US
Telephone Number	:	319-572-1298
Fax Number	:

Provider Business Practice Location Address
First Line	:	2040 SUNNYSIDE AVE
Second Line	:
City	:	BURLINGTON
State	:	IA
Zip	:	52601-2531
Country	:	US
Telephone Number	:	319-572-1298
Fax Number	:

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

Provider Enumeration Date	:	07/29/2011
Last Update Date	:	01/11/2026

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Directions to “ ASHLEY LEE LISW” Practice Location

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