Healthcare Provider Details

I. General information

NPI: 1407761703
Provider Name (Legal Business Name): STILL POND PSYCHIATRY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 WILD ROSE LN STE 400
WEST DES MOINES IA
50266-5351
US

IV. Provider business mailing address

5550 WILD ROSE LN STE 400
WEST DES MOINES IA
50266-5351
US

V. Phone/Fax

Practice location:
  • Phone: 845-551-1159
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DAVID MORALES
Title or Position: NURSE PRACTITIONER IN PSYCHIATRY
Credential: PMHNP-BC
Phone: 845-551-1159