Provider Demographics
NPI:1629712500
Name:CHRISTIANSON, CARA L (LISW)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:L
Last Name:CHRISTIANSON
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:L
Other - Last Name:VOLL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-353-6963
Mailing Address - Fax:319-356-2587
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-353-6963
Practice Address - Fax:319-356-2587
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0953491041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical