NPIMap

Organization Active NPI

Clinical Assessment & Treatment Services PC

  • Clinical Psychologist
  • Des Moines, IA
National Provider Identifier
1760530356
Registry record updated Jul 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
750 Issued in IA
Legal business name
CLINICAL ASSESSMENT & TREATMENT SERVICES PC
Practice address
4313 University Ave
Des Moines, IA 50311-3423
Phone
(515) 255-4211
Fax
(515) 255-4196
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2012

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

Authorized official

Name
Dr. Bruce Lee Dawson, PSY.D.
Title
President
Phone
(515) 255-4211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 750 IA Primary

Addresses

Primary practice location

4313 University Ave
Des Moines, IA 50311-3423

Mailing address

4313 University Ave
Des Moines, IA 50311-3423
Phone (515) 255-4211

Other identifiers 1

IdentifierTypeStateIssuer
43674OtherIAWELLMARK BCBS

National Provider Directory

National Provider Directory

Locations

4313 University Ave
Des Moines, IA 50311
Phone (515) 255-4211

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1342656000000",
    "number": "1760530356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4313 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113423",
            "telephone_number": "515-255-4211",
            "fax_number": "515-255-4196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4313 UNIVERSITY AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503113423",
            "telephone_number": "515-255-4211",
            "fax_number": "515-255-4196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL ASSESSMENT & TREATMENT SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2012-07-19",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-255-4211",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "43674",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2012; 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.