Provider Demographics
NPI:1164685285
Name:BEHAVIORAL HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:BEHAVIORAL HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LP
Authorized Official - Phone:612-314-0646
Mailing Address - Street 1:621 W. LAKE STREET
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408
Mailing Address - Country:US
Mailing Address - Phone:612-314-0646
Mailing Address - Fax:
Practice Address - Street 1:621 WEST LAKE STREET
Practice Address - Street 2:SUITE 350
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408
Practice Address - Country:US
Practice Address - Phone:612-314-0646
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-09
Last Update Date:2016-09-22
Deactivation Date:2016-08-04
Deactivation Code:
Reactivation Date:2016-09-22
Provider Licenses
StateLicense IDTaxonomies
MN3759103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty