Provider Demographics
NPI:1609184282
Name:LURIA, JENNIFER (MSW)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:LURIA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 5TH ST
Mailing Address - Street 2:STE 202
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2939
Mailing Address - Country:US
Mailing Address - Phone:319-358-6520
Mailing Address - Fax:319-538-0093
Practice Address - Street 1:1303 5TH ST
Practice Address - Street 2:STE 202
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2939
Practice Address - Country:US
Practice Address - Phone:319-358-6520
Practice Address - Fax:319-538-0093
Is Sole Proprietor?:No
Enumeration Date:2010-09-17
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007413104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker