Provider Demographics
NPI:1205963196
Name:CANALES, CARLOS ALBERTO (PSYD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ALBERTO
Last Name:CANALES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 WESTOWN PKWY STE 425
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-1434
Mailing Address - Country:US
Mailing Address - Phone:515-664-8290
Mailing Address - Fax:515-528-7771
Practice Address - Street 1:2700 WESTOWN PKWY STE 425
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-1434
Practice Address - Country:US
Practice Address - Phone:515-664-8290
Practice Address - Fax:515-528-7771
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
CAPSY 22237103T00000X
IA072183103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist