Provider Demographics
NPI:1033514948
Name:ROORDA, LANCE (LMSW)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:
Last Name:ROORDA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13926 OAK BROOK DR
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50323-2134
Mailing Address - Country:US
Mailing Address - Phone:515-988-8217
Mailing Address - Fax:
Practice Address - Street 1:3811 38TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-3648
Practice Address - Country:US
Practice Address - Phone:515-339-6677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-04
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA073001104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker