EAGAN COUNSELING CLINIC NPI 1144311184

NPI Information

NPI: 1144311184
Provider Name: EAGAN COUNSELING CLINIC
Classification: Psychologist - 103TC0700X
Specialization: Clinical
Entity Type: Organization
Address: 3450 OLEARY LN
EAGAN, MN
ZIP 55123
Phone: (651) 454-0114

Map and Directions

Get Directions

NPI Details

EAGAN COUNSELING CLINIC is a clinical psychologist in Eagan, MN. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. EAGAN COUNSELING CLINIC NPI is 1144311184. The provider is registered as an organization entity type.

The provider's business location address is:

3450 OLEARY LN
EAGAN, MN
ZIP 55123-340
Phone: (651) 454-0114
Fax: (651) 454-3492

The provider's authorized official is Peggy Dominic .
The authorized official title is Chief Financial Officer and has the following contact phone number (651) 365-8217.

The enumeration date for this NPI number is 9/27/2006 and was last updated on 4/10/2008.

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	251B00000X	Case Management		800689-2-MHC	MINNESOTA	No
2	103TP2701X	Psychologist	Group Psychotherapy	800689-2-MHC	MINNESOTA	No
3	103TC0700X	Psychologist	Clinical	800689-2-MHC	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	101973	OTHER	MINNESOTA	UCARE
2	800084	OTHER	MINNESOTA	PREFERRED ONE
3	59280EA	OTHER	MINNESOTA	BCBS
4	00892	OTHER	MINNESOTA	HEALTH PARTNERS
5	84-57408	OTHER	MINNESOTA	MEDICA
6	C03157	MEDICARE PIN	MINNESOTA

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: 11/21/2025

NPI Synchronization or Removal

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.

Previous NPI

Next NPI