MEDICARE: MULTICULTURAL INTERNATIONAL COUNSELING ENTERPRISES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency	763	IA

General Provider Information

NPI Number	:	1851509020
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MULTICULTURAL INTERNATIONAL COUNSELING ENTERPRISES, P.C.

Provider Business Mailing Address
First Line	:	813 WASHINGTON ST
Second Line	:
City	:	PELLA
State	:	IA
Zip	:	50219-1524
Country	:	US
Telephone Number	:	641-226-6207
Fax Number	:	515-255-4196

Provider Business Practice Location Address
First Line	:	813 WASHINGTON ST
Second Line	:
City	:	PELLA
State	:	IA
Zip	:	50219-1524
Country	:	US
Telephone Number	:	641-226-6207
Fax Number	:	515-255-4196

Authorized Official
Title or Position	:	V-P
Name	:	DR. BRUCE LEE DAWSON
Credential	:	PSY.D.
Telephone Number	:	515-710-9439

Provider Enumeration Date	:	05/19/2007
Last Update Date	:	08/22/2020

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