Provider Demographics
NPI:1588404305
Name:MOUW, LEAH BETH (DSW, LISW, LCSW)
Entity type:Individual
Prefix:
First Name:LEAH
Middle Name:BETH
Last Name:MOUW
Suffix:
Gender:F
Credentials:DSW, LISW, LCSW
Other - Prefix:
Other - First Name:LEAH
Other - Middle Name:
Other - Last Name:SLENK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:700 7TH ST NE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-1671
Mailing Address - Country:US
Mailing Address - Phone:562-746-6740
Mailing Address - Fax:
Practice Address - Street 1:700 7TH ST NE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-1671
Practice Address - Country:US
Practice Address - Phone:562-746-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0983051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty