Great River Psychotherapy Pllc
LBN: Great River Psychotherapy Pllc
Great River Psychotherapy Pllc is an health care organization with primary practice located at 790 Cleveland Ave S Ste 201 , Saint Paul MN 55116-3845. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty.
Great River Psychotherapy Pllc can be contacted via phone (651) 503-7391, or through Rogers, Lisa Paige via phone (651) 503-7391.
Contact Information
Primary practice address
790 Cleveland Ave S Ste 201
Saint Paul MN 55116-3845
Phone: (651) 503-7391
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X |
Profile Details
| NPI number | 1588206940 |
|---|---|
| LBN Legal business name | Great River Psychotherapy Pllc |
| DBA Doing business as | |
| Authorized official | Rogers, Lisa Paige PHD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Oct 16th, 2019 |
| Last updated | Apr 8th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588206940 | NPPES |
| Minnesota | MEDICAID | 680003000 |
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