Theodore R. Liautaud
Organization Active NPI Mental Health Counselor · Lake View, IA
NPI 1487779575 · NPPES record last updated Sep 30, 2008
Key facts
- NPI
- 1487779575
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 01790 (IA)
- Legal business name
- THEODORE R. LIAUTAUD
- Practice address
- 421 E Shore Dr
Lake View, IA 51450 - Phone
- (712) 657-2211
- Fax
- (712) 657-2106
- NPI assigned
- Mar 20, 2007
- Organization subpart
- No
Authorized official
- Name
- Theodore R. Liautaud, DO
- Title
- Owner
- Phone
- (712) 657-2211
Practitioners 3
-
Sharon Ann Arndt-Nelson, ARNP
-
Margaret A Liautaud, LISW
-
Lynn Ann Outlaw, PMHNP
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | 01790 | IA | Yes |
| Psychiatry Physician |
2084P0800X | 01790 | IA |
Addresses
Primary practice location
421 E Shore Dr
Lake View, IA 51450
Mailing address
PO Box 710
421 E Shore Dr
Lake View, IA 51450
Phone (712) 657-2211
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0287888 | Medicaid | IA |
Other names
- Lakes Counseling & Psychiatry
Other providers in Lake View, IA
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- Preferred Image
- Alecia Ann Smith
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- Jenna Sturm
- Bryan Thompson
- Trimark Physicians Group
- Trimark Physicians Group Inc
- Trinity Regional Medical Center
- Elsie Verbik
All providers in Lake View, IA · Mental Health Counselor in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 30, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.