Provider Demographics
NPI:1891804563
Name:LUNKLEY, JUDITH E (LCSW)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:E
Last Name:LUNKLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-0458
Mailing Address - Country:US
Mailing Address - Phone:641-684-6896
Mailing Address - Fax:641-226-5759
Practice Address - Street 1:1015 N 18TH ST STE C
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544-1170
Practice Address - Country:US
Practice Address - Phone:641-856-4400
Practice Address - Fax:641-856-4405
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-14061041C0700X
IA0079101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical