Smith, Joella Jacquelyn
Smith, Joella Jacquelyn is an individual health care provider with primary practice located at 4403 1St Ave Se Ste 309, Cedar Rapids IA 52402-3200. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Smith, Joella Jacquelyn can be contacted via phone (319) 362-0632.Contact Information
Primary practice address
4403 1St Ave Se Ste 309
Cedar Rapids IA 52402-3200
Phone: (319) 362-0632
Fax: (319) 362-5206
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 01360 | Iowa |
Profile Details
| NPI number | 1306824388 |
|---|---|
| LBN Legal business name | Smith, Joella Jacquelyn |
| Credentials | LISW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2006 |
| Last updated | Feb 18th, 2013 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306824388 | NPPES |
| Other | 13498 | WELLMARK | |
| Other | 164104 | WELLMARK | |
| Other | 20032571405 | WELLMARK | |
| Other | 6273362 | WELLMARK | |
| MEDICAID | 0474999 | WELLMARK | |
| Other | 2223660 | WELLMARK | |
| Other | 175396 | WELLMARK |
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