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NPI Code Detail

MEDICARE: INTERPERSONAL PSYCHOTHERAPY INSTITUTE LLC

MEDICARE: INTERPERSONAL PSYCHOTHERAPY INSTITUTE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1932746542
Entity Type Code : Organization
Provider Name (Legal Business Name) : INTERPERSONAL PSYCHOTHERAPY INSTITUTE LLC
Provider Business Mailing Address
First Line : PO BOX 5925
Second Line :
City : CORALVILLE
State : IA
Zip : 52241-0891
Country : US
Telephone Number : 319-321-9998
Fax Number : 877-725-3923
Provider Business Practice Location Address
First Line : 585 W CHERRY ST
Second Line :
City : NORTH LIBERTY
State : IA
Zip : 52317-9797
Country : US
Telephone Number : 319-665-4724
Fax Number :
Authorized Official
Title or Position : DIRECTOR
Name : DR. SCOTT STUART
Credential : MD
Telephone Number : 319-321-9998
Provider Enumeration Date : 12/02/2019
Last Update Date : 09/14/2020

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Directions to “INTERPERSONAL PSYCHOTHERAPY INSTITUTE LLC ” Practice Location

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