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:
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Health care specialties

SpecialtyCodeLicense #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 10 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 1568468312 NPPES
Minnesota MEDICAID 111748300

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