Provider Demographics
NPI:1881751766
Name:INNOVATIVE LEARNING PROFESSIONALS LC
Entity type:Organization
Organization Name:INNOVATIVE LEARNING PROFESSIONALS LC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:GERARD
Authorized Official - Last Name:BEEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:515-270-0280
Mailing Address - Street 1:1001 GRAND AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-3582
Mailing Address - Country:US
Mailing Address - Phone:515-270-0280
Mailing Address - Fax:515-270-1647
Practice Address - Street 1:1001 GRAND AVE STE 201
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-3582
Practice Address - Country:US
Practice Address - Phone:515-270-0280
Practice Address - Fax:515-270-1647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00706103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty