Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 00913 | IA |
Y | 103T00000X | Psychologist | 00913 | IA |
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 00913 | IA |
N | 103G00000X | Clinical Psychologist | 00913 | IA |
N | 103TC0700X | Clinical Psychologist | 00913 | IA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 00913 | IA |
N | 103TE1100X | Exercise & Sports Psychologist | 00913 | IA |
N | 103TF0000X | Family Psychologist | 00913 | IA |
N | 103TP2701X | Group Psychotherapist | 00913 | IA |
NPI | 1629142054 |
---|---|
Provider Name | Dr. Richard James Thorpe |
First Address | Ankeny, IA 50023-4708 |
Second Address | Ankeny, IA 50021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2006 |
Last Update Date | 17/10/2019 |