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NPI Code Detail

MEDICARE: LAVERN EDWARD BULVER LISW

MEDICARE: LAVERN EDWARD BULVER 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
11041C0700XClinical Social Worker06448IA

General Provider Information

NPI Number : 1346746765
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAVERN EDWARD BULVER LISW
Provider Business Mailing Address
First Line : 1316 S MAIN ST
Second Line :
City : CLARION
State : IA
Zip : 50525-2019
Country : US
Telephone Number : 515-532-2811
Fax Number : 319-343-1161
Provider Business Practice Location Address
First Line : 1924 SUPERIOR ST
Second Line :
City : WEBSTER CITY
State : IA
Zip : 50595-3146
Country : US
Telephone Number : 515-832-3332
Fax Number : 515-832-1114
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2018
Last Update Date : 09/18/2024

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Directions to “ LAVERN EDWARD BULVER LISW” Practice Location

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