Provider Demographics
NPI:1316230238
Name:PSYBIZ, INC.
Entity Type:Organization
Organization Name:PSYBIZ, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:O'REGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:612-810-5943
Mailing Address - Street 1:4159 STRAWBERRY LN
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55123-1429
Mailing Address - Country:US
Mailing Address - Phone:612-810-5943
Mailing Address - Fax:
Practice Address - Street 1:155 WABASHA ST S STE 122
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55107-1822
Practice Address - Country:US
Practice Address - Phone:651-983-0383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP1277103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty