Provider Demographics
NPI:1255825816
Name:MCARDLE, LAURA ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:MCARDLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 COURT ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3243
Mailing Address - Country:US
Mailing Address - Phone:712-293-4900
Mailing Address - Fax:712-293-4805
Practice Address - Street 1:2101 COURT ST
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3243
Practice Address - Country:US
Practice Address - Phone:712-293-4900
Practice Address - Fax:712-293-4805
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA008114101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA008114OtherLMSW