Theisen, James Jenkins

Theisen, James Jenkins is an sole proprietor health care provider with primary practice located at 6 E Diamond Lake Rd , Minneapolis MN 55419-1923. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Theisen, James Jenkins can be contacted via phone (612) 237-2752.

Contact Information

Primary practice address
6 E Diamond Lake Rd Minneapolis MN 55419-1923
Phone: (612) 237-2752
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP3639 Minnesota

Profile Details

NPI number 1689673857
LBN Legal business name Theisen, James Jenkins
Credentials PH.D., LP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2005
Last updated Dec 1st, 2023 - about last year

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 1689673857 NPPES
Other 144M0TH BC/BS
Other 61-78532 BC/BS
Other 169040 BC/BS

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