Provider Demographics
NPI:1285367938
Name:ISLEIB, CAROLINA (LMSW)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:ISLEIB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:WADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1150 5TH ST STE 270
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-2933
Mailing Address - Country:US
Mailing Address - Phone:319-804-9312
Mailing Address - Fax:319-449-3845
Practice Address - Street 1:1150 5TH ST STE 270
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-2933
Practice Address - Country:US
Practice Address - Phone:319-804-9312
Practice Address - Fax:319-449-3845
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-08
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1130211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty