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RIVER CITY MENTAL HEALTH CLINIC P.A. NPI 1558348078


NPI Information

NPI: 1558348078
Provider Name: RIVER CITY MENTAL HEALTH CLINIC, P.A.

Other Name: RIVER CITY CLINIC

Classification: Psychologist - 103TC0700X
Entity Type: Organization

Specialization: Clinical

Address:
1360 ENERGY PARK DR
SUITE 340
SAINT PAUL, MN
ZIP 55108
Phone: (651) 646-8985
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RIVER CITY MENTAL HEALTH CLINIC, P.A. is a clinical psychologist in Saint Paul, 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. RIVER CITY MENTAL HEALTH CLINIC, P.A. NPI is 1558348078. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is River City Clinic.

The provider's business location address is:

1360 ENERGY PARK DR
SUITE 340
SAINT PAUL, MN
ZIP 55108-276
Phone: (651) 646-8985
Fax: (651) 646-3959

The provider's authorized official is Mark P Hansen .
The authorized official title is Ceo and has the following contact phone number (651) 312-4569.

The enumeration date for this NPI number is 12/27/2005 and was last updated on 10/8/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC1900XPsychologistCounselingNo
2103TC2200XPsychologistClinical Child & AdolescentNo
3103TF0000XPsychologistFamilyNo
4103T00000XPsychologistNo
5103TP2701XPsychologistGroup PsychotherapyNo
61041C0700XSocial WorkerClinicalNo
7106H00000XMarriage & Family TherapistNo
8101Y00000XCounselorNo
9103G00000XClinical NeuropsychologistNo
10103TC0700XPsychologistClinicalYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1155441700MEDICAIDMINNESOTA
242G12RIOTHERMINNESOTABCBS MN
341G99RIOTHERMINNESOTABCBS MN
442G08RIOTHERMINNESOTABCBS MN
5C01993MEDICARE PINMINNESOTA
698534OTHERMINNESOTAPERFERRED ONE
785234OTHERMINNESOTAHEALTH PARTNERS

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: 4/28/2024

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.