Stephanie Untiedt, Phd, Llc

LBN: Stephanie Untiedt, Phd, Llc
Stephanie Untiedt, Phd, Llc is an health care organization with primary practice located at 5101 Olson Memorial Hwy Ste 4007 , Golden Valley MN 55422-5164. The organization recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as the primary health care specialty. Stephanie Untiedt, Phd, Llc can be contacted via phone (763) 595-7294, or through Untiedt, Stephanie Ann via phone (763) 595-7294.

Contact Information

Primary practice address
5101 Olson Memorial Hwy Ste 4007 Golden Valley MN 55422-5164
Phone: (763) 595-7294
Fax: (763) 595-7293
Website:
Map and Directions
Authorized official contact:
Name: Untiedt, Stephanie Ann PHD
Phone: (763) 595-7294

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 4599 Minnesota

Profile Details

NPI number 1073903886
LBN Legal business name Stephanie Untiedt, Phd, Llc
DBA Doing business as
Authorized official Untiedt, Stephanie Ann PHD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 1st, 2015
Last updated Feb 1st, 2015 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073903886 NPPES
Minnesota MEDICAID 1093756041

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