Van Siclen, Robert Cornell

Van Siclen, Robert Cornell is an sole proprietor health care provider with primary practice located at 277 Coon Rapids Blvd Nw Suite 308, Coon Rapids MN 55433-5843. He recently has 4 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 / Psychologist. Behavioral Health & Social Service Providers / Cognitive & Behavioral is his primary health care specialty. Van Siclen, Robert Cornell can be contacted via phone (763) 717-4979.

Contact Information

Primary practice address
277 Coon Rapids Blvd Nw Suite 308 Coon Rapids MN 55433-5843
Phone: (763) 717-4979
Fax: (763) 717-4954
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X LP2775 Minnesota
Behavioral Health & Social Service Providers / Clinical 103TC0700X LP2775 Minnesota
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X LP2775 Minnesota
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP2775 Minnesota

Profile Details

NPI number 1871674978
LBN Legal business name Van Siclen, Robert Cornell
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2006
Last updated Jul 8th, 2007 - about 18 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 1871674978 NPPES
Minnesota Other 3K444VA BLUE CROSS BLUE SHIELD
Minnesota Other 108029 BLUE CROSS BLUE SHIELD
Minnesota Other 61-20060 BLUE CROSS BLUE SHIELD

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