Provider Demographics
NPI:1619906799
Name:LEUTZINGER, CASSIE JO (PSYD)
Entity type:Individual
Prefix:DR
First Name:CASSIE
Middle Name:JO
Last Name:LEUTZINGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 OFFICE PARK RD STE 215
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-2505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:939 OFFICE PARK RD STE 215
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50265-2505
Practice Address - Country:US
Practice Address - Phone:515-579-5047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001045103TC0700X
NE625103TC0700X, 103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLID582ZMedicare UPIN
NE246564OtherMIDLANDS CHOICE
NE470798717OtherTRIWEST
NED08488OtherBCBS
NEQ49302Medicare UPIN
NE10024969000Medicaid
NE246564OtherMIDLANDS CHOICE
NE10024968900Medicaid
NED08488OtherBCBS
NE470798717-29Medicaid