Provider Demographics
NPI:1467772731
Name:CALZADA, NICOLAS STEPHEN (LMSW)
Entity Type:Individual
Prefix:
First Name:NICOLAS
Middle Name:STEPHEN
Last Name:CALZADA
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 N 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-1836
Mailing Address - Country:US
Mailing Address - Phone:641-752-1585
Mailing Address - Fax:641-752-9665
Practice Address - Street 1:9 N 4TH AVE
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-1836
Practice Address - Country:US
Practice Address - Phone:641-752-1585
Practice Address - Fax:641-752-9665
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0058230Medicaid
IA1942251160OtherBCBS
IA1942251160OtherBCBS