Provider Demographics
NPI:1235440454
Name:NIEUWSMA, JEANETTA E (LISW)
Entity type:Individual
Prefix:
First Name:JEANETTA
Middle Name:E
Last Name:NIEUWSMA
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 1:383 223RD PL
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-7666
Mailing Address - Country:US
Mailing Address - Phone:712-314-2152
Mailing Address - Fax:
Practice Address - Street 1:604 LIBERTY ST STE 231
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1777
Practice Address - Country:US
Practice Address - Phone:712-314-2152
Practice Address - Fax:712-314-2152
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0074861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA007486OtherIOWA LICENSE