Provider Demographics
NPI:1568527422
Name:METHENEY, DENISE L (LISW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:L
Last Name:METHENEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:DL
Other - Middle Name:
Other - Last Name:METHENEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:300 W HUTCHINGS ST
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-2104
Mailing Address - Country:US
Mailing Address - Phone:515-462-2373
Mailing Address - Fax:515-462-3105
Practice Address - Street 1:300 W HUTCHINGS ST
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-2104
Practice Address - Country:US
Practice Address - Phone:515-462-2373
Practice Address - Fax:515-462-3105
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IALISW 06479101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0600528Medicaid
IA161326Medicare ID - Type Unspecified