Chavis, Kenneth Marshall

Chavis, Kenneth Marshall is an sole proprietor health care provider with primary practice located at 4005 W 65Th St Suite 108, Edina MN 55435-1720. He recently has only one registered license in Behavioral Health & Social Service Providers / Counseling, which is considered as his primary health care specialty. Chavis, Kenneth Marshall can be contacted via phone (952) 922-9090.

Contact Information

Primary practice address
4005 W 65Th St Suite 108 Edina MN 55435-1720
Phone: (952) 922-9090
Fax: (952) 929-0022
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X MN LP2329 Minnesota

Profile Details

NPI number 1841347978
LBN Legal business name Chavis, Kenneth Marshall
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 4th, 2007
Last updated Jul 8th, 2007 - about 17 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 1841347978 NPPES
Minnesota Other 59609CH BLUE CROSS BLUE SHIELD
Minnesota Other 075466 BLUE CROSS BLUE SHIELD
Minnesota Other 4616961 BLUE CROSS BLUE SHIELD
Minnesota Other 874001 BLUE CROSS BLUE SHIELD

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