Healthcare Provider Details

I. General information

NPI: 1093895641
Provider Name (Legal Business Name): URIAH MCGEE CADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 8TH ST
DES MOINES IA
50309-1539
US

IV. Provider business mailing address

620 8TH ST
DES MOINES IA
50309-1539
US

V. Phone/Fax

Practice location:
  • Phone: 515-697-5700
  • Fax:
Mailing address:
  • Phone: 515-697-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number94120
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: