=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801609680
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TRULU PSYCHIATRY, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2025
-----------------------------------------------------
Last Update Date | 03/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 332 S LINN ST STE 1
-----------------------------------------------------
City | IOWA CITY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52240-1697
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-251-3376
-----------------------------------------------------
Fax | 319-205-6121
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 308 E BURLINGTON ST # 134
-----------------------------------------------------
City | IOWA CITY
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52240-1602
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-251-3376
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | AUTHORIZED OFFICIAL
-----------------------------------------------------
Name | SANDRA FINNEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 319-251-3376
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------