Provider Demographics
NPI:1568792497
Name:SWITZER, KELLI SUE (LISW, RPT/S)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:SUE
Last Name:SWITZER
Suffix:
Gender:F
Credentials:LISW, RPT/S
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:SUE
Other - Last Name:WATERBECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:127 BAILEY PARK RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:52361-9529
Mailing Address - Country:US
Mailing Address - Phone:319-415-8484
Mailing Address - Fax:
Practice Address - Street 1:1061 COURT AVE
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IA
Practice Address - Zip Code:52301-1439
Practice Address - Country:US
Practice Address - Phone:319-642-3031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007045104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker