Provider Demographics
NPI:1184914582
Name:BEARDSLEY, KATE (LISW)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:BEARDSLEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:STRALKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:1441 W CENTRAL PARK AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804-1707
Mailing Address - Country:US
Mailing Address - Phone:563-383-1900
Mailing Address - Fax:563-884-4638
Practice Address - Street 1:1441 W CENTRAL PARK AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804-1707
Practice Address - Country:US
Practice Address - Phone:563-383-1900
Practice Address - Fax:563-884-4638
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007656104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker