| Clinical Assessment & Treatment Services Pc | |
|
4313 University Ave Des Moines IA 50311-3423 | |
| (515) 255-4211 | |
| (515) 255-4196 |
| Full Name | Clinical Assessment & Treatment Services Pc |
|---|---|
| Speciality | Psychologist |
| Location | 4313 University Ave, Des Moines, Iowa |
| Authorized Official Name and Position | Bruce Lee Dawson (PRESIDENT) |
| Authorized Official Contact | 5152554211 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinical Assessment & Treatment Services Pc 4313 University Ave Des Moines IA 50311-3423 Ph: (515) 255-4211 | Clinical Assessment & Treatment Services Pc 4313 University Ave Des Moines IA 50311-3423 Ph: (515) 255-4211 |
| NPI Number | 1760530356 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 07/19/2012 |
| Medicare PECOS PAC ID | 4981685344 |
|---|---|
| Medicare Enrollment ID | O20040601000475 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760530356 | NPI | - | NPPES |
| 43674 | Other | IA | WELLMARK BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 750 (Iowa) | Primary |
| Provider Name | Bruce L Dawson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902954589 PECOS PAC ID: 0143201509 Enrollment ID: I20120720000391 |
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