Provider Demographics
NPI:1972625119
Name:WARMBIER, CAROL GORDON (LISW)
Entity type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:GORDON
Last Name:WARMBIER
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:CAROL
Other - Middle Name:ANN
Other - Last Name:GORDON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:IA
Mailing Address - Zip Code:50548-0474
Mailing Address - Country:US
Mailing Address - Phone:515-295-3334
Mailing Address - Fax:515-295-3337
Practice Address - Street 1:117 E CALL ST
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:IA
Practice Address - Zip Code:50511-2444
Practice Address - Country:US
Practice Address - Phone:515-295-3334
Practice Address - Fax:515-295-3337
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA024811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA11764704OtherCAQH
IA138200OtherHEALTH ALLIANCE
IA252903OtherMIDLANDS CHOICE
IA55339OtherBLUE CROSS
IA1972625199Medicaid
IA2163631OtherCOMPSYCH
IAI20576Medicare PIN