Provider Demographics
NPI:1356429591
Name:BAUERLE, KAREN R (LISW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:R
Last Name:BAUERLE
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 1:2611 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-7924
Mailing Address - Country:US
Mailing Address - Phone:641-628-9599
Mailing Address - Fax:641-621-1493
Practice Address - Street 1:6200 AURORA AVE STE 302W
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-2864
Practice Address - Country:US
Practice Address - Phone:515-331-0303
Practice Address - Fax:515-331-9086
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA062411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1356429591Medicaid
IA1356429591Medicaid