Provider Demographics
NPI:1427002641
Name:CLINICAL HEALTH PSYCHOLOGISTS, PLC
Entity Type:Organization
Organization Name:CLINICAL HEALTH PSYCHOLOGISTS, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NAOMI
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:MCCORMICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:319-240-7456
Mailing Address - Street 1:P.O. BOX 1066
Mailing Address - Street 2:CLINICAL HEALTH PSYCHOLOGISTS, PLC
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-0048
Mailing Address - Country:US
Mailing Address - Phone:319-240-7456
Mailing Address - Fax:
Practice Address - Street 1:2717 MINNETONKA DR
Practice Address - Street 2:CLINICAL HEALTH PSYCHOLOGISTS, PLC
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-1531
Practice Address - Country:US
Practice Address - Phone:319-240-7456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36264OtherBLUE CROSS BLUE SHIELD
IA708085000Medicaid
IA36264OtherBLUE CROSS BLUE SHIELD