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General NPI Number Information
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NPI Number | 1104509140
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Entity Type | Organization
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Legal Business Name | HOLISTIC WELLNESS & PSYCHIATRY
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 10 W CHERRY ST
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City | NORTH LIBERTY
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State | IA
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Zip | 52317-8822
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Country | US
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Telephone | 319-800-2125
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Fax | 855-300-4759
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Provider Business Mailing Address
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Address Line | 42 7TH AVE SW STE 100
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City | CEDAR RAPIDS
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State | IA
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Zip | 52404-2185
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Country | US
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Telephone | 319-800-2125
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Fax | 855-300-4759
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Authorized Official
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Title or Position | OWNER
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Name | LAURIE MAY MCCORMICK
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Credential | MD
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Telephone | 319-471-1749
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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