Provider Demographics
NPI:1013215557
Name:OSLAND, VICKI LYNN (LMSW, CADC)
Entity Type:Individual
Prefix:
First Name:VICKI
Middle Name:LYNN
Last Name:OSLAND
Suffix:
Gender:F
Credentials:LMSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DRIVE
Mailing Address - Street 2:C124 GH
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1046
Mailing Address - Country:US
Mailing Address - Phone:319-356-8935
Mailing Address - Fax:319-384-9362
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:C124 GH
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1007
Practice Address - Country:US
Practice Address - Phone:319-356-8935
Practice Address - Fax:319-384-9362
Is Sole Proprietor?:No
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01113101YA0400X
IA064981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)