1851403091 NPI number — CLAIRE ELIZABETH DICKEY LICHT LMHC

Table of content: CLAIRE ELIZABETH DICKEY LICHT LMHC (NPI 1851403091)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851403091 NPI number — CLAIRE ELIZABETH DICKEY LICHT LMHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LICHT
Provider First Name:
CLAIRE
Provider Middle Name:
ELIZABETH DICKEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMHC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DICKEY
Provider Other First Name:
CLAIRE
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMHC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1851403091
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
209 EAST WASHINGTON STREET
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
IOWA CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
52240-3928
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
319-354-3232
Provider Business Mailing Address Fax Number:
319-354-2990

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 EAST WASHINGTON STREET
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
IOWA CITY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
52240-3928
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
319-354-3232
Provider Business Practice Location Address Fax Number:
319-354-2990
Provider Enumeration Date:
08/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  00017 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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