Provider Demographics
NPI:1144381807
Name:ELGERS, LYNDA L (MA, CADC)
Entity Type:Individual
Prefix:MS
First Name:LYNDA
Middle Name:L
Last Name:ELGERS
Suffix:
Gender:F
Credentials:MA, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 S FREDERICK AVE
Mailing Address - Street 2:P.O. BOX 113
Mailing Address - City:OELWEIN
Mailing Address - State:IA
Mailing Address - Zip Code:50662-2305
Mailing Address - Country:US
Mailing Address - Phone:319-283-5774
Mailing Address - Fax:319-283-5775
Practice Address - Street 1:36 S FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-2305
Practice Address - Country:US
Practice Address - Phone:319-283-5774
Practice Address - Fax:319-283-5775
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2009-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
IA08101101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health