CAROL B. PETERSON PH.D. L.P. LLC NPI 1114932522

NPI Information

NPI: 1114932522
Provider Name: CAROL B. PETERSON PH.D., L.P., LLC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
5101 OLSON MEMORIAL HWY
SUITE 4005
GOLDEN VALLEY, MN
ZIP 55422
Phone: (763) 595-7294
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CAROL B. PETERSON PH.D., L.P., LLC is a mental health (including community mental health center) clinic center in Golden Valley, MN. CAROL B. PETERSON PH.D., L.P., LLC NPI is 1114932522. The provider is registered as an organization entity type.

The provider's business location address is:

5101 OLSON MEMORIAL HWY
SUITE 4005
GOLDEN VALLEY, MN
ZIP 55422-149
Phone: (763) 595-7294
Fax: (763) 595-7293

The provider's authorized official is Carol Brooke Peterson .
The authorized official title is Licensed Psychologist and has the following contact phone number (763) 595-7294.

The enumeration date for this NPI number is 7/31/2006 and was last updated on 8/22/2020.

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
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	LP3201	MINNESOTA	Yes

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

NPI Synchronization or Removal

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