Provider Demographics
NPI:1649321811
Name:NICOLA, ARLENE MARIE (MSW, LISW)
Entity type:Individual
Prefix:MRS
First Name:ARLENE
Middle Name:MARIE
Last Name:NICOLA
Suffix:
Gender:
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 7TH AVE N
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-3122
Mailing Address - Country:US
Mailing Address - Phone:515-573-3382
Mailing Address - Fax:515-573-3336
Practice Address - Street 1:318 7TH AVE N
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-3122
Practice Address - Country:US
Practice Address - Phone:515-573-3382
Practice Address - Fax:515-573-3336
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36434OtherWELLMARK
IA18729Medicare ID - Type Unspecified