Provider Demographics
NPI:1992246409
Name:ISENHOUR, VICTORIA ROSE (LMSW)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ROSE
Last Name:ISENHOUR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 JEFFERSON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-9056
Mailing Address - Country:US
Mailing Address - Phone:319-325-2988
Mailing Address - Fax:
Practice Address - Street 1:222 3RD ST SE STE 322
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-1508
Practice Address - Country:US
Practice Address - Phone:319-313-7781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0788741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical