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Organization
PAX PSYCHOTHERAPY, PLLC
Active
Organization
PAX PSYCHOTHERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REINA ELIZABETH NORIEGA (CREDENTIALING COORDINATOR)
(515) 505-5498
Entity
Organization
Contact information
Practice address
2963 100TH ST STE 3, URBANDALE, IA 50322-5513
(515) 380-4266
Mailing address
2963 100TH ST STE 3, URBANDALE, IA 50322-5513
(515) 380-4266
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
NULL
101YM0800X
Mental Health Counselor
Primary
—
—
103T00000X
Psychologist
—
NULL
103T00000X
Psychologist
—
—
103TC1900X
Counseling Psychologist
—
NULL
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
NULL
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
1041C0700X
Clinical Social Worker
—
NULL
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
NULL
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
—
NULL
2084P0800X
Psychiatry Physician
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
NULL
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
05/03/2024
Last updated
05/03/2024
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