Provider Demographics
NPI:1750329314
Name:CHILD PSYCHIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:CHILD PSYCHIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND MD
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:E
Authorized Official - Last Name:KUNZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-288-5570
Mailing Address - Street 1:939 OFFICE PARK RD
Mailing Address - Street 2:STE 200
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2505
Mailing Address - Country:US
Mailing Address - Phone:515-288-5570
Mailing Address - Fax:515-440-3388
Practice Address - Street 1:939 OFFICE PARK RD
Practice Address - Street 2:STE 200
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2505
Practice Address - Country:US
Practice Address - Phone:515-288-5570
Practice Address - Fax:515-440-3388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI6716Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER