Provider Demographics
NPI:1255684239
Name:MAURA PEGLAR, LISW,ACSW,PLC
Entity Type:Organization
Organization Name:MAURA PEGLAR, LISW,ACSW,PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEGLAR
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:515-232-2051
Mailing Address - Street 1:600 5TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6071
Mailing Address - Country:US
Mailing Address - Phone:515-232-2051
Mailing Address - Fax:
Practice Address - Street 1:600 5TH ST STE 200
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6071
Practice Address - Country:US
Practice Address - Phone:515-232-2051
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty