Integrative Psychology Services Pllc | |
13375 University Ave Ste 200a Clive IA 50325-8261 | |
(515) 421-8250 | |
(515) 724-7860 |
Full Name | Integrative Psychology Services Pllc |
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Speciality | Psychologist |
Location | 13375 University Ave Ste 200a, Clive, Iowa |
Authorized Official Name and Position | Kevin Kilcawley (LICENSED PSYCHOLOGIST) |
Authorized Official Contact | 5154218250 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Integrative Psychology Services Pllc 13375 University Ave Ste 200a Clive IA 50325-8261 Ph: (515) 421-8250 | Integrative Psychology Services Pllc 13375 University Ave Ste 200a Clive IA 50325-8261 Ph: (515) 421-8250 |
NPI Number | 1730645102 |
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Provider Enumeration Date | 02/11/2019 |
Last Update Date | 08/06/2024 |
Certification Date | 08/06/2024 |
Medicare PECOS PAC ID | 2567893787 |
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Medicare Enrollment ID | O20200502000208 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730645102 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
Provider Name | Kevin G Kilcawley |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1710383757 PECOS PAC ID: 3971808320 Enrollment ID: I20160223000092 |
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