Provider Demographics
NPI:1992856132
Name:OLMSTED, BRENDA RENEE (LISW)
Entity Type:Individual
Prefix:MISS
First Name:BRENDA
Middle Name:RENEE
Last Name:OLMSTED
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 1:3494 QUAIL TRAIL CT
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-9467
Mailing Address - Country:US
Mailing Address - Phone:319-377-2161
Mailing Address - Fax:319-377-2094
Practice Address - Street 1:5250 N PARK PL NE
Practice Address - Street 2:SUITE 209
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6221
Practice Address - Country:US
Practice Address - Phone:319-377-2161
Practice Address - Fax:319-377-2094
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA066441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical