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ASSOCIATED CLINIC OF PSYCHOLOGY INC NPI 1588741292


NPI Information

NPI: 1588741292
Provider Name: ASSOCIATED CLINIC OF PSYCHOLOGY INC
Classification: Clinic/Center - 261QM0801X
Entity Type: Organization

Specialization: Mental Health (Including Community Mental Health Center)

Address:
4027 COUNTY ROAD 25
ST LOUIS PARK, MN
ZIP 55416
Phone: (612) 925-6033
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ASSOCIATED CLINIC OF PSYCHOLOGY INC is a mental health (including community mental health center) clinic center in St Louis Park, MN. ASSOCIATED CLINIC OF PSYCHOLOGY INC NPI is 1588741292. The provider is registered as an organization entity type.

The provider's business location address is:

4027 COUNTY ROAD 25
ST LOUIS PARK, MN
ZIP 55416
Phone: (612) 925-6033
Fax: (612) 925-8496

The provider's authorized official is John E Brose .
The authorized official title is Ceo and has the following contact phone number (612) 925-6033.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 9/6/2018.


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
1261QM0855XClinic/CenterAdolescent and Children Mental Health811029-1-MHCMINNESOTANo
2261QM0850XClinic/CenterAdult Mental Health811029-1-MHCMINNESOTANo
3261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)811029-1-MHCMINNESOTAYes

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
1277723100MEDICAIDMINNESOTA
23920OTHERMINNESOTAHEALTHPARTNERS
3475-94ASOTHERMINNESOTABCBS
4CT0661OTHERMINNESOTARAILROAD MEDICARE

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: 11/14/2023

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.