Provider Demographics
NPI:1659760825
Name:HELDENBRAND, LISA MARIE (MSW, LMSW)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:HELDENBRAND
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 S 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:IA
Mailing Address - Zip Code:50047-9638
Mailing Address - Country:US
Mailing Address - Phone:515-491-6690
Mailing Address - Fax:
Practice Address - Street 1:2600 GRAND AVE STE 130
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50312-5300
Practice Address - Country:US
Practice Address - Phone:515-243-3525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006958104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker