Provider Demographics
NPI:1063895241
Name:KUNKEL, LISA (CADC)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:KUNKEL
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 1ST ST SE
Mailing Address - Street 2:
Mailing Address - City:BELMOND
Mailing Address - State:IA
Mailing Address - Zip Code:50421-1201
Mailing Address - Country:US
Mailing Address - Phone:641-444-3500
Mailing Address - Fax:641-444-5688
Practice Address - Street 1:403 1ST ST SE
Practice Address - Street 2:
Practice Address - City:BELMOND
Practice Address - State:IA
Practice Address - Zip Code:50421-1201
Practice Address - Country:US
Practice Address - Phone:641-444-5621
Practice Address - Fax:641-444-5688
Is Sole Proprietor?:No
Enumeration Date:2015-07-07
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)