Provider Demographics
NPI:1841705712
Name:CADE, PETER T (MDIV, MS, LMHC)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:T
Last Name:CADE
Suffix:
Gender:M
Credentials:MDIV, MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7405 UNIVERSITY AVE STE 6
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-1343
Mailing Address - Country:US
Mailing Address - Phone:515-779-0780
Mailing Address - Fax:515-277-6995
Practice Address - Street 1:7405 UNIVERSITY AVE STE 6
Practice Address - Street 2:
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-1343
Practice Address - Country:US
Practice Address - Phone:515-779-0780
Practice Address - Fax:515-277-6995
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2017-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA088399101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health