Provider Demographics
NPI:1417220104
Name:TREEHOUSE PSYCHOLOGY, PLLC
Entity Type:Organization
Organization Name:TREEHOUSE PSYCHOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:651-243-1513
Mailing Address - Street 1:500 HIGHWAY 96 W STE 400
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-1959
Mailing Address - Country:US
Mailing Address - Phone:651-243-1513
Mailing Address - Fax:651-203-7370
Practice Address - Street 1:500 HIGHWAY 96 W
Practice Address - Street 2:SUITE 400
Practice Address - City:SHOREVIEW
Practice Address - State:MN
Practice Address - Zip Code:55126-1944
Practice Address - Country:US
Practice Address - Phone:651-243-1513
Practice Address - Fax:651-203-7370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-11
Last Update Date:2012-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP5296103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty