| Blank Mental Health Providers | |
|
1206 Pleasant St. Des Moines IA 50309-1453 | |
| (515) 241-3434 | |
| (515) 241-8631 |
| Full Name | Blank Mental Health Providers |
|---|---|
| Speciality | Psychologist |
| Location | 1206 Pleasant St., Des Moines, Iowa |
| Authorized Official Name and Position | Joseph F. Corfits (C.F.O.) |
| Authorized Official Contact | 5152416470 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blank Mental Health Providers 1206 Pleasant St. Des Moines IA 50309-1453 Ph: (515) 241-3434 | Blank Mental Health Providers 1206 Pleasant St. Des Moines IA 50309-1453 Ph: (515) 241-3434 |
| NPI Number | 1497007710 |
|---|---|
| Provider Enumeration Date | 10/10/2012 |
| Last Update Date | 10/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497007710 | NPI | - | NPPES |
| 0736603 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (Iowa) | Primary |
| 103TC2200X | Psychologist - Clinical Child & Adolescent | (Iowa) | Secondary |
| 104100000X | Social Worker | (Iowa) | Secondary |
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