Provider Demographics
NPI:1730110909
Name:CHUHA, JOELLEN H (MSW,LISW)
Entity Type:Individual
Prefix:MRS
First Name:JOELLEN
Middle Name:H
Last Name:CHUHA
Suffix:
Gender:F
Credentials:MSW,LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 HICKMAN RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-5300
Mailing Address - Country:US
Mailing Address - Phone:515-251-8882
Mailing Address - Fax:515-251-8889
Practice Address - Street 1:9001 HICKMAN RD
Practice Address - Street 2:SUITE 350
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-5300
Practice Address - Country:US
Practice Address - Phone:515-251-8882
Practice Address - Fax:515-251-8889
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA057531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0434449Medicaid
IAI11464Medicare ID - Type Unspecified