Provider Demographics
NPI:1659628881
Name:HARTEL, JEAN ELEANOR (LISW)
Entity Type:Individual
Prefix:MS
First Name:JEAN
Middle Name:ELEANOR
Last Name:HARTEL
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 1:200 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:319-356-1453
Mailing Address - Fax:319-356-8284
Practice Address - Street 1:799 MAIN ST
Practice Address - Street 2:STE 230
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6844
Practice Address - Country:US
Practice Address - Phone:563-556-3700
Practice Address - Fax:563-583-3702
Is Sole Proprietor?:No
Enumeration Date:2012-08-07
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA052861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical