Provider Demographics
NPI:1497481626
Name:LINCOLN, ROBERT DUANE (LMSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:DUANE
Last Name:LINCOLN
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 1:604 LAFAYETTE ST FL 2
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:641-330-0455
Mailing Address - Fax:515-220-2272
Practice Address - Street 1:604 LAFAYETTE ST FL 2
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:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA05182104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1710503982Medicaid