Provider Demographics
NPI:1710761762
Name:DREYER, CHANTAL (LMSW)
Entity Type:Individual
Prefix:
First Name:CHANTAL
Middle Name:
Last Name:DREYER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:CHANTAL
Other - Middle Name:
Other - Last Name:DREYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:402 3RD AVE.
Mailing Address - Street 2:
Mailing Address - City:US CENTRAL
Mailing Address - State:IA
Mailing Address - Zip Code:52216
Mailing Address - Country:US
Mailing Address - Phone:563-920-4606
Mailing Address - Fax:
Practice Address - Street 1:402 3RD AVE.
Practice Address - Street 2:
Practice Address - City:US CENTRAL
Practice Address - State:IA
Practice Address - Zip Code:52216
Practice Address - Country:US
Practice Address - Phone:563-920-4606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1183661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical