Provider Demographics
NPI:1750499976
Name:LAPHAM, AMY BETH (LISW)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:BETH
Last Name:LAPHAM
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 W MADISON ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51449-1020
Mailing Address - Country:US
Mailing Address - Phone:515-979-5412
Mailing Address - Fax:
Practice Address - Street 1:819 W MADISON ST
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:IA
Practice Address - Zip Code:51449-1020
Practice Address - Country:US
Practice Address - Phone:515-979-5412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-28
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA025811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA19600OtherWELLMARK