Provider Demographics
NPI:1114912870
Name:OLMSTEAD, KAREN LEE (LISW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEE
Last Name:OLMSTEAD
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:LEE
Other - Last Name:MCGOWAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-0843
Mailing Address - Fax:319-353-7788
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-0843
Practice Address - Fax:319-353-7788
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00135104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA26578OtherWELLMARK BCBS
P27613Medicare UPIN
IA26578OtherWELLMARK BCBS