Organization
PENCROFT PSYCHOLOGY ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANN MARIE JENISON LISW (SOLE MEMBER)
(515) 218-1901
Entity
Organization
Contact information
Practice address
2600 GRAND AVE, SUITE 102, DES MOINES, IA 50312-5375
(515) 218-1901
(515) 274-6913
Mailing address
2213 GRAND AVE, DES MOINES, IA 50312-5305
(515) 237-3974
(515) 883-2692
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
00679
IA
Other
Enumeration date
01/13/2016
Last updated
01/28/2016
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