Provider Demographics
NPI:1003261868
Name:HANNENBERG, VALERIE (LISW)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HANNENBERG
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:VALERIE
Other - Middle Name:
Other - Last Name:WESTFALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:1030 5TH AVE SE
Mailing Address - Street 2:SUITE 3000
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403
Mailing Address - Country:US
Mailing Address - Phone:319-286-4545
Mailing Address - Fax:319-368-3358
Practice Address - Street 1:1824 W 8TH ST
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-2056
Practice Address - Country:US
Practice Address - Phone:319-277-0992
Practice Address - Fax:319-277-5768
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA080579101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health