Provider Demographics
NPI:1407421084
Name:LENZ, BAILEY (LMSW)
Entity Type:Individual
Prefix:
First Name:BAILEY
Middle Name:
Last Name:LENZ
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 1:604 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50703-4708
Mailing Address - Country:US
Mailing Address - Phone:833-370-0719
Mailing Address - Fax:515-220-2272
Practice Address - Street 1:604 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-4708
Practice Address - Country:US
Practice Address - Phone:833-370-0719
Practice Address - Fax:515-220-2272
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1074341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical