Provider Demographics
NPI:1063788602
Name:MULTICULTURAL INTERNATIONAL COUNSELING ENTERPRISES, INC.
Entity type:Organization
Organization Name:MULTICULTURAL INTERNATIONAL COUNSELING ENTERPRISES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINIC DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANA
Authorized Official - Middle Name:MERCEDES
Authorized Official - Last Name:LOPEZ-DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, PSYD
Authorized Official - Phone:515-802-2487
Mailing Address - Street 1:311 FRANKLIN STREET
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219
Mailing Address - Country:US
Mailing Address - Phone:515-802-2487
Mailing Address - Fax:641-204-0068
Practice Address - Street 1:311 FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219
Practice Address - Country:US
Practice Address - Phone:515-802-2487
Practice Address - Fax:641-204-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00763103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty