Provider Demographics
NPI:1679639843
Name:LACONA, JAMI LYNN (LISW)
Entity Type:Individual
Prefix:MS
First Name:JAMI
Middle Name:LYNN
Last Name:LACONA
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:JAMI
Other - Middle Name:LYNN
Other - Last Name:CIRIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:3408 WOODLAND AVE
Mailing Address - Street 2:SUITE 210 D
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-6506
Mailing Address - Country:US
Mailing Address - Phone:515-421-7891
Mailing Address - Fax:515-608-4484
Practice Address - Street 1:3408 WOODLAND AVE
Practice Address - Street 2:SUITE 210 D
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-6506
Practice Address - Country:US
Practice Address - Phone:515-421-7891
Practice Address - Fax:515-608-4484
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA058851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical