Healthcare Provider Details

I. General information

NPI: 1558607390
Provider Name (Legal Business Name): STEPHEN ALLEN PICKEN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2012
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 100TH ST
URBANDALE IA
50322-3808
US

IV. Provider business mailing address

8845 LAKE DR
WEST DES MOINES IA
50266-1651
US

V. Phone/Fax

Practice location:
  • Phone: 541-574-9570
  • Fax: 515-564-7101
Mailing address:
  • Phone: 515-608-2374
  • Fax: 515-564-7101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: