Gottlieb, Jeffrey
Gottlieb, Jeffrey is an individual health care provider with primary practice located at 2545 Chicago Avenue South Mob Building, 7Th Floor, Minneapolis MN 55404. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Gottlieb, Jeffrey can be contacted via phone (612) 863-4471.Contact Information
Primary practice address
2545 Chicago Avenue South Mob Building, 7Th Floor
Minneapolis MN 55404
Phone: (612) 863-4471
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | LP1651 | Minnesota |
Profile Details
NPI number | 1568468312 |
---|---|
LBN Legal business name | Gottlieb, Jeffrey |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 27th, 2005 |
Last updated | Mar 20th, 2015 - about 9 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1568468312 | NPPES |
Minnesota | MEDICAID | 111748300 |
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