Provider Demographics
NPI:1427787282
Name:DEVERICKS, ALYSSA HOPE (MSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:HOPE
Last Name:DEVERICKS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:ZETTERLUND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1522 MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-4028
Mailing Address - Country:US
Mailing Address - Phone:319-524-0510
Mailing Address - Fax:
Practice Address - Street 1:1522 MORGAN ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-4028
Practice Address - Country:US
Practice Address - Phone:319-524-0510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker