Close, Richard Edwin
Close, Richard Edwin is an individual health care provider with primary practice located at 3450 Oleary Ln , Eagan MN 55123-2340. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Close, Richard Edwin can be contacted via phone (651) 454-0114.Contact Information
Primary practice address
3450 Oleary Ln
Eagan MN 55123-2340
Phone: (651) 454-0114
Fax: (651) 454-3492
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Marriage & Family Therapist | 106H00000X | 0067 | Minnesota |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 07734 | Minnesota |
Profile Details
| NPI number | 1457379026 |
|---|---|
| LBN Legal business name | Close, Richard Edwin |
| Credentials | DMIN, MA,LICSW, LMFT |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2006 |
| Last updated | Dec 15th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457379026 | NPPES |
| Minnesota | MEDICAID | 636357100 |
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