Provider Demographics
NPI:1225437064
Name:PLAINS AREA MENTAL HEALTH
Entity Type:Organization
Organization Name:PLAINS AREA MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MASTERS SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:LICHTENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:712-263-3172
Mailing Address - Street 1:20 N 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:IA
Mailing Address - Zip Code:51442-2026
Mailing Address - Country:US
Mailing Address - Phone:712-263-3172
Mailing Address - Fax:
Practice Address - Street 1:20 N 14TH ST
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-2026
Practice Address - Country:US
Practice Address - Phone:712-263-3172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA109328601251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health