Stefanie Louise Dingbaum, LISW
Individual provider Active NPI Clinical Social Worker · Manchester, IA
NPI 1942986096 · NPPES record last updated Jan 29, 2024
Key facts
- NPI
- 1942986096
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 095355 (IA)
- Practice address
- 105 E Butler St
Manchester, IA 52057-1606 - Phone
- (563) 929-6571
- NPI assigned
- Jun 23, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231212000279 | IA | Practitioner - Clinical Social Worker | 2769831106 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 095355 | IA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waves Healing Therapy, LLC | Clinical | Current |
Accepting new patients |
Locations
1212 W Marion St
Manchester, IA 52057
Phone (563) 822-0081
105 E Butler St
Manchester, IA 52057
Phone (563) 927-3759
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 095355 | IA | Yes |
Addresses
Primary practice location
105 E Butler St
Manchester, IA 52057-1606
Mailing address
217 Summit St
Earlville, IA 52041-2562
Phone (563) 608-4281
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 095355 | Other | IA | LISW |
Other providers in Manchester, IA
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Delaware County Memorial Hospital
- Dental Associates of Manchester
- Angela Cae Detmering
- Blanka Divisova
- Dubuque Internal Medicine PC
- Dunn Chiropractic Clinic
- Garry M Dunn
- Derek Manson Dzaboff
All providers in Manchester, IA · Clinical Social Worker in Iowa
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.