Provider Type Icon

QUAD CITIES MENTAL HEALTH NPI 1679010771


NPI Information

NPI: 1679010771
Provider Name: QUAD CITIES MENTAL HEALTH
Classification: Psychologist - 103TP0016X
Entity Type: Organization

Specialization: Prescribing (Medical)

Address:
4350 7TH ST
MOLINE, IL
ZIP 61265
Phone: (309) 764-5040
Get Directions

QUAD CITIES MENTAL HEALTH is a prescribing (medical) psychologist in Moline, IL. The provider is a licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended. QUAD CITIES MENTAL HEALTH NPI is 1679010771. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4350 7TH ST
MOLINE, IL
ZIP 61265-870
Phone: (309) 764-5040
Fax: (309) 764-9001

The provider's authorized official is Gonchigari Narayana .
The authorized official title is Owner and has the following contact phone number (309) 764-5040.

The enumeration date for this NPI number is 1/26/2017 and was last updated on 1/26/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1103TP0016XPsychologistPrescribing (Medical)336.042316ILLINOISYes
2251S00000XCommunity/Behavioral Health180.006915ILLINOISNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.