| Iowa Center For Psychological Health, Inc | |
|
333 Sw 9th St Suite J Des Moines IA 50309-4440 | |
| (515) 777-3075 | |
| (515) 777-1719 |
| Full Name | Iowa Center For Psychological Health, Inc |
|---|---|
| Speciality | Social Worker |
| Location | 333 Sw 9th St, Des Moines, Iowa |
| Authorized Official Name and Position | Gloria Tallulah Krause (DIRECTOR OUTPATIENT SERVICES) |
| Authorized Official Contact | 5155540878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iowa Center For Psychological Health, Inc 147 Paine St Se Ste J Bondurant IA 50035-1003 Ph: (515) 554-0878 | Iowa Center For Psychological Health, Inc 333 Sw 9th St Suite J Des Moines IA 50309-4440 Ph: (515) 777-3075 |
| NPI Number | 1336487016 |
|---|---|
| Provider Enumeration Date | 01/30/2013 |
| Last Update Date | 05/05/2021 |
| Certification Date | 05/05/2021 |
| Medicare PECOS PAC ID | 5799058970 |
|---|---|
| Medicare Enrollment ID | O20170911001146 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336487016 | NPI | - | NPPES |
| 600993023 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007236 (Iowa) | Primary |
| Provider Name | Gloria T Krause |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669604278 PECOS PAC ID: 3577872985 Enrollment ID: I20151027000815 |
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