Healthcare Provider Details

I. General information

NPI: 1720361868
Provider Name (Legal Business Name): KATHLEEN CAREY MATTHEWS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2011
Last Update Date: 10/26/2025
Certification Date: 10/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4090 WESTOWN PKWY STE E
WEST DES MOINES IA
50266-6760
US

IV. Provider business mailing address

4090 WESTOWN PKWY STE E
WEST DES MOINES IA
50266-6760
US

V. Phone/Fax

Practice location:
  • Phone: 515-421-8554
  • Fax:
Mailing address:
  • Phone: 515-421-8554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number001340
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number001340
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: