Provider Demographics
NPI:1831138635
Name:RUND, EDWARD (LISW)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:RUND
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 W BURLINGTON
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-3242
Mailing Address - Country:US
Mailing Address - Phone:515-282-2319
Mailing Address - Fax:515-282-3234
Practice Address - Street 1:600 EAST COURT STE 200
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2021
Practice Address - Country:US
Practice Address - Phone:515-243-3525
Practice Address - Fax:515-243-3448
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA01205104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker