River Vale Psychology Clinic
LBN: Nicole M. Johnson, Psyd, Lp, Llc
River Vale Psychology Clinic is an health care organization with primary practice located at 200 E Travelers Trl Ste 205 , Burnsville MN 55337-4191. The organization recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Cognitive & Behavioral, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty.
Nicole M. Johnson, Psyd, Lp, Llc can be contacted via phone (612) 249-0269, or through Lp, Nicole M. Johnson Psyd via phone (612) 249-0287.
Contact Information
Primary practice address
200 E Travelers Trl Ste 205
Burnsville MN 55337-4191
Phone: (612) 249-0269
Fax: (612) 249-8540
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Cognitive & Behavioral | 103TB0200X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | ||
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X |
Profile Details
| NPI number | 1649893587 |
|---|---|
| LBN Legal business name | Nicole M. Johnson, Psyd, Lp, Llc |
| DBA Doing business as | River Vale Psychology Clinic |
| Authorized official | Lp, Nicole M. Johnson Psyd LP |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 27th, 2020 |
| Last updated | Sep 11th, 2020 - about 5 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649893587 | NPPES |
| Minnesota | Other | 1649893587 | NPI II |
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