Provider Demographics
NPI:1861591901
Name:CENTRAL IOWA THERAPY ASSOCIATES INC
Entity type:Organization
Organization Name:CENTRAL IOWA THERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:515-291-8889
Mailing Address - Street 1:6310 PRAIRIE RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014
Mailing Address - Country:US
Mailing Address - Phone:515-291-8889
Mailing Address - Fax:515-292-7698
Practice Address - Street 1:906 9TH ST
Practice Address - Street 2:STE. 218
Practice Address - City:BOONE
Practice Address - State:IA
Practice Address - Zip Code:50036-2760
Practice Address - Country:US
Practice Address - Phone:515-291-8889
Practice Address - Fax:515-292-7698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA156106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty