Provider Demographics
NPI:1699288118
Name:WICKWIRE CHEEK, DANA MICHELLE (LISW)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:MICHELLE
Last Name:WICKWIRE CHEEK
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:MICHELLE
Other - Last Name:WICKWIRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:2795 REED AVE
Mailing Address - Street 2:
Mailing Address - City:GARNER
Mailing Address - State:IA
Mailing Address - Zip Code:50438-8548
Mailing Address - Country:US
Mailing Address - Phone:515-290-0057
Mailing Address - Fax:
Practice Address - Street 1:2795 REED AVE
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:IA
Practice Address - Zip Code:50438-8548
Practice Address - Country:US
Practice Address - Phone:515-518-0636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-06
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA97118101YA0400X
MO202010197441041C0700X
IA065511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)