Provider Demographics
NPI:1124456454
Name:WINTERTON, DAVID SCOT (LISW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOT
Last Name:WINTERTON
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 1:505 5TH AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-2324
Mailing Address - Country:US
Mailing Address - Phone:515-244-6090
Mailing Address - Fax:515-284-5201
Practice Address - Street 1:505 5TH AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-2324
Practice Address - Country:US
Practice Address - Phone:515-244-6090
Practice Address - Fax:515-284-5201
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA07020101YA0400X
IA037991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)