Provider Demographics
NPI:1164665006
Name:HEMESATH, CYNTHIA (LISW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:HEMESATH
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 BLAIRS FERRY RD
Mailing Address - Street 2:MERCY FAMILY COUNSELING
Mailing Address - City:HIAWATHA
Mailing Address - State:IA
Mailing Address - Zip Code:52233
Mailing Address - Country:US
Mailing Address - Phone:319-398-6575
Mailing Address - Fax:
Practice Address - Street 1:1340 BLAIRS FERRY RD
Practice Address - Street 2:
Practice Address - City:HIAWATHA
Practice Address - State:IA
Practice Address - Zip Code:52233-1900
Practice Address - Country:US
Practice Address - Phone:319-398-6575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06575104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker