Provider Demographics
NPI:1285920850
Name:FLATHERS, CHRISTINE MARIE (LISW)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:FLATHERS
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 1:420 KELLOGG AVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6226
Mailing Address - Country:US
Mailing Address - Phone:515-233-3141
Mailing Address - Fax:515-233-2440
Practice Address - Street 1:125 S 3RD ST
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-7042
Practice Address - Country:US
Practice Address - Phone:515-233-2250
Practice Address - Fax:515-233-3235
Is Sole Proprietor?:No
Enumeration Date:2011-06-22
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010039053104100000X
IA008070104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1285920850Medicaid
IA1841357894Medicaid