Sutherland, Roy John

Sutherland, Roy John is an sole proprietor health care provider with primary practice located at 1900 Silver Lake Rd Nw , New Brighton MN 55112-1786. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counseling, Behavioral Health & Social Service Providers / Psychologist. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Sutherland, Roy John can be contacted via phone (651) 628-9566.

Contact Information

Primary practice address
1900 Silver Lake Rd Nw New Brighton MN 55112-1786
Phone: (651) 628-9566
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counseling 103TC1900X LP5295 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP5295 Minnesota

Profile Details

NPI number 1073820379
LBN Legal business name Sutherland, Roy John
Credentials PHD, ABPP,LADC,MHA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 8th, 2010
Last updated May 6th, 2022 - about 3 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 1073820379 NPPES
Minnesota MEDICAID 1073820379

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