Whiteside, Douglas Michael

Whiteside, Douglas Michael is an individual health care provider with primary practice located at 909 Fulton St Se , Minneapolis MN 55455-4800. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical Neuropsychologist, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Whiteside, Douglas Michael can be contacted via phone (612) 672-7422.

Contact Information

Primary practice address
909 Fulton St Se Minneapolis MN 55455-4800
Phone: (612) 672-7422
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X LP6425 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X 073858 Iowa
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2492 Washington
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP6425 Minnesota

Profile Details

NPI number 1346280971
LBN Legal business name Whiteside, Douglas Michael
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Mar 24th, 2021 - about 5 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 1346280971 NPPES
Minnesota Other LP6425 STATE LICENSE
Minnesota Other 2492 STATE LICENSE
Minnesota Other 071008267 STATE LICENSE

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