Provider Demographics
NPI:1881855047
Name:POGEL, DEBORAH (LISW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
Last Name:POGEL
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 1:2142 OPAL LN
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-8646
Mailing Address - Country:US
Mailing Address - Phone:641-455-8400
Mailing Address - Fax:
Practice Address - Street 1:2142 OPAL LN
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-8646
Practice Address - Country:US
Practice Address - Phone:641-455-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06709104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA107314000OtherIOWA PLAN