Provider Demographics
NPI:1730143546
Name:WESTIN-YOCKEY, DOROTHY (LISW)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:WESTIN-YOCKEY
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 1:409 KENYON RD STE C
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5718
Mailing Address - Country:US
Mailing Address - Phone:515-573-3138
Mailing Address - Fax:515-573-3130
Practice Address - Street 1:4301 SERGEANT RD
Practice Address - Street 2:SUITE 203
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-4726
Practice Address - Country:US
Practice Address - Phone:712-276-9000
Practice Address - Fax:712-276-4917
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA008171041C0700X
NE1540101YM0800X
NE8081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAS11855Medicare UPIN