| Consulting Psychologists Associates | |
|
501 Dale St N 213 Saint Paul MN 55103-1914 | |
| (651) 225-0954 | |
| Not Available |
| Full Name | Consulting Psychologists Associates |
|---|---|
| Speciality | Psychologist |
| Location | 501 Dale St N, Saint Paul, Minnesota |
| Authorized Official Name and Position | Bruce Keith Thordal (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 6512250854 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Consulting Psychologists Associates 2870 Highview Ter Eagan MN 55121-1110 Ph: (651) 225-0854 | Consulting Psychologists Associates 501 Dale St N 213 Saint Paul MN 55103-1914 Ph: (651) 225-0954 |
| NPI Number | 1740559699 |
|---|---|
| Provider Enumeration Date | 12/22/2011 |
| Last Update Date | 12/22/2011 |
| Medicare PECOS PAC ID | 5597926832 |
|---|---|
| Medicare Enrollment ID | O20120413000483 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740559699 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TB0200X | Psychologist - Cognitive & Behavioral | LP1135 (Minnesota) | Primary |
| Provider Name | Bruce Keith Thordal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417091455 PECOS PAC ID: 6406017748 Enrollment ID: I20120413000506 |
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