Provider Demographics
NPI:1730599341
Name:DISALVO, WINDY J (LMSW, PLMHP (FOR NEB)
Entity type:Individual
Prefix:MRS
First Name:WINDY
Middle Name:J
Last Name:DISALVO
Suffix:
Gender:F
Credentials:LMSW, PLMHP (FOR NEB
Other - Prefix:
Other - First Name:WINDY
Other - Middle Name:J
Other - Last Name:ROTTENBUCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, PLMHP
Mailing Address - Street 1:PO BOX 8-C
Mailing Address - Street 2:NORTH 6TH AND AVE E.
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51502-3008
Mailing Address - Country:US
Mailing Address - Phone:712-322-3700
Mailing Address - Fax:712-325-8200
Practice Address - Street 1:719 MILL ST.
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51502-3008
Practice Address - Country:US
Practice Address - Phone:712-326-5906
Practice Address - Fax:712-323-6968
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10235101YM0800X
IA075547101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health