Provider Demographics
NPI:1669538989
Name:SWOBODA, EILEEN DOHN (MSW)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:DOHN
Last Name:SWOBODA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149 S HICKORY BLVD
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:IA
Mailing Address - Zip Code:50327-7129
Mailing Address - Country:US
Mailing Address - Phone:515-262-5376
Mailing Address - Fax:
Practice Address - Street 1:2327 70TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-4825
Practice Address - Country:US
Practice Address - Phone:515-270-1344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA10091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1035006Medicaid