Provider Demographics
NPI:1235643651
Name:CLINKSCALES, STEVE FRANK
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:FRANK
Last Name:CLINKSCALES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 VINE ST
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-4472
Mailing Address - Country:US
Mailing Address - Phone:515-758-7091
Mailing Address - Fax:515-209-7081
Practice Address - Street 1:1211 VINE ST STE 2210
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-4469
Practice Address - Country:US
Practice Address - Phone:515-758-7091
Practice Address - Fax:515-209-7081
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA17069101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)