Provider Demographics
NPI:1568984516
Name:SCHMADEKE, CARISSA (LISW)
Entity Type:Individual
Prefix:
First Name:CARISSA
Middle Name:
Last Name:SCHMADEKE
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 1:3316 CEDAR HEIGHTS DR STE C
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6448
Mailing Address - Country:US
Mailing Address - Phone:319-260-2066
Mailing Address - Fax:319-575-6101
Practice Address - Street 1:3316 CEDAR HEIGHTS DR STE C
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6448
Practice Address - Country:US
Practice Address - Phone:319-260-2066
Practice Address - Fax:319-575-6101
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-12
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA086377104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker