Close, Richard Edwin

Close, Richard Edwin is an individual health care provider with primary practice located at 3450 Oleary Ln , Eagan MN 55123-2340. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Close, Richard Edwin can be contacted via phone (651) 454-0114.

Contact Information

Primary practice address
3450 Oleary Ln Eagan MN 55123-2340
Phone: (651) 454-0114
Fax: (651) 454-3492
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0067 Minnesota
Behavioral Health & Social Service Providers / Clinical 1041C0700X 07734 Minnesota

Profile Details

NPI number 1457379026
LBN Legal business name Close, Richard Edwin
Credentials DMIN, MA,LICSW, LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Dec 15th, 2018 - about 6 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 1457379026 NPPES
Minnesota MEDICAID 636357100

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