Thinesen, Paul John

Thinesen, Paul John is an sole proprietor health care provider with primary practice located at 2565 Morningside Rd , Long Lake MN 55356-9109. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Thinesen, Paul John can be contacted via phone (651) 263-0763.

Contact Information

Primary practice address
2565 Morningside Rd Long Lake MN 55356-9109
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 0762 Minnesota

Profile Details

NPI number 1982774352
LBN Legal business name Thinesen, Paul John
Credentials MA LP BCBA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 9th, 2006
Last updated May 18th, 2010 - about 14 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 1982774352 NPPES
Minnesota Other 6190806 MEDICA
Minnesota Other 84G16TH MEDICA
Minnesota Other 191308 MEDICA
Minnesota MEDICAID 232850000 MEDICA

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