Healthcare Provider Details
I. General information
NPI: 1023630340
Provider Name (Legal Business Name): STRIDE AUTISM CENTERS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/08/2020
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2680 FLEUR DR
DES MOINES IA
50321-1756
US
IV. Provider business mailing address
2680 FLEUR DR
DES MOINES IA
50321-1756
US
V. Phone/Fax
- Phone: 515-207-5251
- Fax: 877-372-2427
- Phone:
- Fax: 877-372-2427
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KRISTEN
COOPER BORKENHAGEN
Title or Position: PRESIDENT
Credential: BCBA, LMFT
Phone: 408-460-6871