Provider Demographics
NPI:1891862934
Name:RESOURCES IN PSYCHIATRY
Entity type:Organization
Organization Name:RESOURCES IN PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:D
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:515-490-0749
Mailing Address - Street 1:1922 INGERSOLL AVE STE 132
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-3339
Mailing Address - Country:US
Mailing Address - Phone:515-490-0749
Mailing Address - Fax:515-280-7786
Practice Address - Street 1:1922 INGERSOLL AVE STE 132
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3339
Practice Address - Country:US
Practice Address - Phone:515-490-0749
Practice Address - Fax:515-280-7786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02464103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA02464OtherIA BOARD OF MEDICAL EXAMI
IAF25459Medicare UPIN