Nystrom, Brian Arthur

Nystrom, Brian Arthur is an individual health care provider with primary practice located at Brighton Professional Bldg 1900 Silver Lake Road #110, New Brighton MN 55112-1789. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Nystrom, Brian Arthur can be contacted via phone (651) 628-9566.

Contact Information

Primary practice address
Brighton Professional Bldg 1900 Silver Lake Road #110 New Brighton MN 55112-1789
Phone: (651) 628-9566
Fax: (651) 628-0411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 06197 Minnesota
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0145 Minnesota

Profile Details

NPI number 1326075813
LBN Legal business name Nystrom, Brian Arthur
Credentials L.I.C.S.W., L.M.F.T.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 28th, 2006
Last updated May 27th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326075813 NPPES
Minnesota MEDICAID 001857100

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