Provider Demographics
NPI:1639458433
Name:CAVES, MEGAN ELISE OTTO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:ELISE OTTO
Last Name:CAVES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6950 NE 14TH ST STE 36
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-8903
Mailing Address - Country:US
Mailing Address - Phone:515-289-1515
Mailing Address - Fax:515-289-1511
Practice Address - Street 1:6950 NE 14TH ST STE 36
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-8903
Practice Address - Country:US
Practice Address - Phone:515-289-1515
Practice Address - Fax:515-289-1511
Is Sole Proprietor?:No
Enumeration Date:2011-08-10
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
IA001268103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA058230010Medicare PIN