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NPI Code Detail

MEDICARE: REBECCA CRANDALL LISW

MEDICARE: REBECCA CRANDALL 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
1104100000XSocial Worker095348IA

General Provider Information

NPI Number : 1740835750
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA CRANDALL LISW
Provider Business Mailing Address
First Line : 1408 INGERSOLL RD
Second Line :
City : WATERLOO
State : IA
Zip : 50701-6048
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3301 CEDAR HEIGHTS DR
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-6041
Country : US
Telephone Number : 319-529-9985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2019
Last Update Date : 02/02/2026

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Directions to “ REBECCA CRANDALL LISW” Practice Location

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