| Mcclintock Psychiatry Services Llc | |
|
1728 Central Ave Suite 14 Fort Dodge IA 50501-4200 | |
| (515) 955-1836 | |
| (515) 955-7115 |
| Full Name | Mcclintock Psychiatry Services Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1728 Central Ave, Fort Dodge, Iowa |
| Authorized Official Name and Position | Holly Mcclintock (PSYCHIATRIC NURSE PRACTITIONER) |
| Authorized Official Contact | 5155749803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcclintock Psychiatry Services Llc 1728 Central Ave Suite 14 Fort Dodge IA 50501-4200 Ph: (515) 955-1836 | Mcclintock Psychiatry Services Llc 1728 Central Ave Suite 14 Fort Dodge IA 50501-4200 Ph: (515) 955-1836 |
| NPI Number | 1407250715 |
|---|---|
| Provider Enumeration Date | 10/15/2014 |
| Last Update Date | 08/09/2024 |
| Certification Date | 08/09/2024 |
| Medicare PECOS PAC ID | 6002356391 |
|---|---|
| Medicare Enrollment ID | O20240913000443 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407250715 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | G122426 (Iowa) | Primary |
| Provider Name | Holly A Mcclintock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558656876 PECOS PAC ID: 3274783915 Enrollment ID: I20121015000737 |
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