Provider Demographics
NPI:1124494380
Name:HEMPEL BUCY, ERICA LAUREN (LISW)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:LAUREN
Last Name:HEMPEL BUCY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:LAUREN
Other - Last Name:HEMPEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1333 W. LOMBARD ST. STE C
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52804
Mailing Address - Country:US
Mailing Address - Phone:563-505-1850
Mailing Address - Fax:309-786-0205
Practice Address - Street 1:1333 W. LOMBARD ST. STE C
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52804
Practice Address - Country:US
Practice Address - Phone:563-324-9050
Practice Address - Fax:309-786-0205
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150-014449104100000X
IA0081841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker