Healthcare Provider Details

I. General information

NPI: 1215926811
Provider Name (Legal Business Name): DON CALVIN DAMSTEEGT PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 11/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 CENTER POINT RD NE
CEDAR RAPIDS IA
52402-6571
US

IV. Provider business mailing address

1221 CENTER POINT RD NE
CEDAR RAPIDS IA
52402-6571
US

V. Phone/Fax

Practice location:
  • Phone: 319-378-1199
  • Fax: 319-378-7497
Mailing address:
  • Phone: 319-378-1199
  • Fax: 319-378-7497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number00432
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier11683
Identifier TypeOTHER
Identifier StateIN
Identifier IssuerMIDLANDS
# 2
Identifier15433
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerWELLMARK BXBS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: