Provider Demographics
NPI:1285072744
Name:DOWNING, ANNIE MARIE (LISW, RPT)
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:MARIE
Last Name:DOWNING
Suffix:
Gender:F
Credentials:LISW, RPT
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 132
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:IA
Mailing Address - Zip Code:51351-0132
Mailing Address - Country:US
Mailing Address - Phone:712-338-6200
Mailing Address - Fax:712-338-6205
Practice Address - Street 1:910 10TH ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:IA
Practice Address - Zip Code:51351
Practice Address - Country:US
Practice Address - Phone:712-338-6200
Practice Address - Fax:712-338-6205
Is Sole Proprietor?:No
Enumeration Date:2013-06-06
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0070751041C0700X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1285072744Medicaid