| Clinton Keith Cunningham, | |
|
405 Monroe St, Pella, IA 50219-1290 | |
| (641) 621-2200 | |
| (641) 621-2335 |
| Full Name | Clinton Keith Cunningham |
|---|---|
| Gender | Male |
| Speciality | Marriage & Family Therapist |
| Location | 405 Monroe St, Pella, Iowa |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215410741 | NPI | - | NPPES |
| 1215410741 | Other | IA | NPI # |
| LMFT-16160 | Other | AZ | OTHER |
| LMFT-16160 | Medicaid | AZ | |
| 007829 | Other | IA | IOWA LICENSE |
| 087027 | Other | IA | IOWA LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 087027 (Iowa) | Primary |
| Entity Name | Qv Urgent Care Ia Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407465917 PECOS PAC ID: 1052722147 Enrollment ID: O20201120001496 |
| Entity Name | Ankeny Family Counseling |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053804617 PECOS PAC ID: 6103364666 Enrollment ID: O20240814004637 |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton Keith Cunningham, 405 Monroe St, Pella, IA 50219-1290 Ph: (641) 621-2200 | Clinton Keith Cunningham, 405 Monroe St, Pella, IA 50219-1290 Ph: (641) 621-2200 |
Mrs. Darla Joy De Haan, MA Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 315 Main St, Pella, IA 50219 Phone: 641-628-1723 Fax: 641-628-1723 | |
Mr. Matthew Joseph Burch, M.A. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 315 Main St, Pella, IA 50219 Phone: 641-628-1723 Fax: 641-628-1723 | |
Joseph Thomas Graybill, Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 315 Main St, Pella, IA 50219 Phone: 641-628-1723 |