Psychology Iowa PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

PSYCHOLOGY IOWA PLLC

Practice address

3703 Douglas Ave
Des Moines, IA 50310-5347

Phone

(515) 277-4357

NPI assigned

Sep 4, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jeffrey Scott Kinderdietz, PHD

Title

Clinical Psychologist

Phone

(515) 277-4357

Specialties & licenses 1

Addresses

Other names 1

• Psychology Iowa Other name

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1567555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570492800000",
    "number": "1245889104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105347",
            "telephone_number": "515-277-4357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 DOUGLAS AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503105347",
            "telephone_number": "515-277-4357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY IOWA PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-04",
        "last_updated": "2019-10-08",
        "status": "A",
        "authorized_official_last_name": "KINDERDIETZ",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "515-277-4357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Psychology Iowa",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Clinical Psychologist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Clinical Psychologist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.