Provider Demographics
NPI:1275624017
Name:KLATT, LU (MSW, LISW, ACSW)
Entity Type:Individual
Prefix:
First Name:LU
Middle Name:
Last Name:KLATT
Suffix:
Gender:F
Credentials:MSW, LISW, ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 5TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6085
Mailing Address - Country:US
Mailing Address - Phone:515-232-2051
Mailing Address - Fax:515-232-2775
Practice Address - Street 1:600 5TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6085
Practice Address - Country:US
Practice Address - Phone:515-232-2051
Practice Address - Fax:515-232-2775
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA888104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA34791OtherWELLMARK BC/BS (FOR CENTRAL IOWA PSYCH. SVCS. PRACTICE LOCATION)
IA56057OtherWELLMARK BC/BS - MY 5TH ST. PRACTICE LOCATION
IAI1905002Medicare PIN