Provider Demographics
NPI:1598334211
Name:VANDER ZWAAG, JOSHUA (LISW)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:VANDER ZWAAG
Suffix:
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2202 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4560
Mailing Address - Country:US
Mailing Address - Phone:515-291-3950
Mailing Address - Fax:515-295-0216
Practice Address - Street 1:2202 PINEHURST DR
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4560
Practice Address - Country:US
Practice Address - Phone:515-291-3950
Practice Address - Fax:515-295-0216
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-18
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA108653104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker