Provider Demographics
NPI:1205506458
Name:JULIE MCCLATCHEY, LISW, PC
Entity type:Organization
Organization Name:JULIE MCCLATCHEY, LISW, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLATCHEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LISW
Authorized Official - Phone:515-884-8802
Mailing Address - Street 1:1609 NW 125TH ST
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-8153
Mailing Address - Country:US
Mailing Address - Phone:515-240-3644
Mailing Address - Fax:
Practice Address - Street 1:5000 WESTOWN PKWY STE 100
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5921
Practice Address - Country:US
Practice Address - Phone:515-884-8802
Practice Address - Fax:515-884-8846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-19
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health