| Highland Psychiatric Services Pa | |
|
897 St Paul Ave St Paul MN 55116 | |
| (651) 698-4443 | |
| (651) 698-4817 |
| Full Name | Highland Psychiatric Services Pa |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 897 St Paul Ave, St Paul, Minnesota |
| Authorized Official Name and Position | Suzy Ellen Peterson (OWNER) |
| Authorized Official Contact | 6516984443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Highland Psychiatric Services Pa 897 St Paul Ave St Paul MN 55116 Ph: (651) 698-4443 | Highland Psychiatric Services Pa 897 St Paul Ave St Paul MN 55116 Ph: (651) 698-4443 |
| NPI Number | 1891884326 |
|---|---|
| Provider Enumeration Date | 10/12/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 8628178159 |
|---|---|
| Medicare Enrollment ID | O20070712000194 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891884326 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Suzy E Peterson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114961372 PECOS PAC ID: 6103822416 Enrollment ID: I20061010000450 |
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