Provider Demographics
NPI:1407250715
Name:MCCLINTOCK PSYCHIATRY SERVICES LLC
Entity type:Organization
Organization Name:MCCLINTOCK PSYCHIATRY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCLINTOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-302-8072
Mailing Address - Street 1:114 N 27TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4322
Mailing Address - Country:US
Mailing Address - Phone:515-302-8072
Mailing Address - Fax:515-302-8076
Practice Address - Street 1:114 N 27TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4322
Practice Address - Country:US
Practice Address - Phone:515-302-8072
Practice Address - Fax:515-302-8076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-15
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty