Healthcare Provider Details

I. General information

NPI: 1710810858
Provider Name (Legal Business Name): CHRISTOPHER DERIX
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

553 HIGHFIELD DR
SAINT CHARLES MO
63304-7143
US

IV. Provider business mailing address

3408 WOODLAND AVE STE 102
WEST DES MOINES IA
50266-6504
US

V. Phone/Fax

Practice location:
  • Phone: 515-207-5226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER DERIX
Title or Position: PSYCHOLOGIST
Credential: PSYD
Phone: 515-207-5226