Provider Demographics
NPI:1649164484
Name:LC PSYCHIATRY
Entity type:Organization
Organization Name:LC PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:LAVON
Authorized Official - Last Name:CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:515-707-6777
Mailing Address - Street 1:2303 SW 17TH ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7087
Mailing Address - Country:US
Mailing Address - Phone:515-707-6777
Mailing Address - Fax:
Practice Address - Street 1:8460 BIRCHWOOD CT STE 700
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2806
Practice Address - Country:US
Practice Address - Phone:515-707-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty