Provider Demographics
NPI:1811009053
Name:PINI, JANE ANN (LISW)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:PINI
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ANN
Other - Last Name:EGERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:209 EAST WASHINGTON STREET
Mailing Address - Street 2:SUITE 202
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-3928
Mailing Address - Country:US
Mailing Address - Phone:319-354-3232
Mailing Address - Fax:319-354-2990
Practice Address - Street 1:209 EAST WASHINGTON STREET
Practice Address - Street 2:SUITE 202
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-3928
Practice Address - Country:US
Practice Address - Phone:319-354-3232
Practice Address - Fax:319-354-2990
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00873104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0250530Medicaid
IA43570OtherBCBS IA
IA0250530Medicaid