Provider Demographics
NPI:1780663674
Name:JAGER-PIPPY, RHONDA M (MSW, LISW)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:M
Last Name:JAGER-PIPPY
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 1:20 W 4TH ST
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4013
Mailing Address - Country:US
Mailing Address - Phone:712-262-6111
Mailing Address - Fax:712-262-6180
Practice Address - Street 1:20 W 4TH ST
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4013
Practice Address - Country:US
Practice Address - Phone:712-262-6111
Practice Address - Fax:712-262-6180
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA032371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36707OtherWELLMARK BCBS
414655OtherVALUE OPTIONS
IA0440636Medicaid
414655OtherVALUE OPTIONS
Q18823Medicare UPIN