Provider Demographics
NPI:1558861575
Name:BERTO, NATALIE MICHELLE (LISW)
Entity Type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:MICHELLE
Last Name:BERTO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 N DODGE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-5911
Mailing Address - Country:US
Mailing Address - Phone:641-777-5594
Mailing Address - Fax:
Practice Address - Street 1:708 5TH ST STE 4
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2339
Practice Address - Country:US
Practice Address - Phone:641-777-5594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0081551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical