Provider Demographics
NPI:1003073925
Name:PUTZ, CAROL (LMSW, MSED)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:PUTZ
Suffix:
Gender:F
Credentials:LMSW, MSED
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:
Other - Last Name:CASKEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW, MSED
Mailing Address - Street 1:PO BOX 224
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-0224
Mailing Address - Country:US
Mailing Address - Phone:515-233-8473
Mailing Address - Fax:
Practice Address - Street 1:319 LINCOLN WAY
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-3309
Practice Address - Country:US
Practice Address - Phone:515-233-8473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01624104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker