Provider Demographics
NPI:1487872719
Name:LUMSDEN, JEAN (CRC, LMFT)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:
Last Name:LUMSDEN
Suffix:
Gender:F
Credentials:CRC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 ARIZONA ST
Mailing Address - Street 2:
Mailing Address - City:GLIDDEN
Mailing Address - State:IA
Mailing Address - Zip Code:51443-1021
Mailing Address - Country:US
Mailing Address - Phone:712-830-2545
Mailing Address - Fax:712-659-3867
Practice Address - Street 1:115 E LINCOLNWAY ST STE 340
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:IA
Practice Address - Zip Code:50129-2146
Practice Address - Country:US
Practice Address - Phone:712-830-2545
Practice Address - Fax:712-659-3867
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA042114101Y00000X
IA000299106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA042114OtherC.R.C. NO.