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General NPI Number Information
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NPI Number | 1205506458
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Entity Type | Organization
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Legal Business Name | JULIE MCCLATCHEY, LISW, PC
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Dates
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Enumeration Date | 09/19/2021
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Last Update Date | 10/20/2021
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Provider Practice Location Address
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Address Line | 5000 WESTOWN PKWY STE 100
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City | WEST DES MOINES
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State | IA
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Zip | 50266-5921
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Country | US
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Telephone | 515-884-8802
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Fax | 515-884-8846
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Provider Business Mailing Address
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Address Line | 1609 NW 125TH ST
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City | CLIVE
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State | IA
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Zip | 50325-8153
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Country | US
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Telephone | 515-240-3644
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE MCCLATCHEY
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Credential | MSW, LISW
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Telephone | 515-884-8802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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