1942630728 NPI number — MULTICULTURAL PSYCHOTHERAPY AND CONSULTING SERVICES LTD

Table of content: (NPI 1942630728)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942630728 NPI number — MULTICULTURAL PSYCHOTHERAPY AND CONSULTING SERVICES LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MULTICULTURAL PSYCHOTHERAPY AND CONSULTING SERVICES LTD
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942630728
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/15/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4471 HIGHWAY 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARDEN HILLS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55112-1952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-702-3483
Provider Business Mailing Address Fax Number:
651-633-1219

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3133 HENNEPIN AVE SOUTH
Provider Second Line Business Practice Location Address:
(LOWER LEVEL)
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55408-2620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-702-3483
Provider Business Practice Location Address Fax Number:
651-633-1219
Provider Enumeration Date:
11/15/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ-PETROVICH
Authorized Official First Name:
KATIA
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
612-702-3483

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  2238 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com