Provider Demographics
NPI:1104895408
Name:SCHLOSSER, ANITA V (MSW)
Entity type:Individual
Prefix:MS
First Name:ANITA
Middle Name:V
Last Name:SCHLOSSER
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:PO BOX 1762
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-1762
Mailing Address - Country:US
Mailing Address - Phone:515-292-2703
Mailing Address - Fax:515-292-5044
Practice Address - Street 1:511 DUFF AVE
Practice Address - Street 2:STE 100
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6391
Practice Address - Country:US
Practice Address - Phone:515-292-2703
Practice Address - Fax:515-292-5044
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-17
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA006001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0174656Medicaid
IA00916Medicare ID - Type Unspecified