Provider Demographics
NPI:1689751042
Name:OMAN, JENNIFER LOCK (LISW)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LOCK
Last Name:OMAN
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 1:1001 OFFICE PARK RD
Mailing Address - Street 2:STE 206
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2509
Mailing Address - Country:US
Mailing Address - Phone:515-277-6133
Mailing Address - Fax:
Practice Address - Street 1:1001 OFFICE PARK RD
Practice Address - Street 2:STE 206
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2509
Practice Address - Country:US
Practice Address - Phone:515-277-6133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
48288OtherWELLMARK BCBS OF IOWA
48288OtherWELLMARK BCBS OF IOWA