Provider Demographics
NPI:1457304941
Name:BEHAVIORAL PSYCHOLOGICAL CONSULTANTS LTD
Entity Type:Organization
Organization Name:BEHAVIORAL PSYCHOLOGICAL CONSULTANTS LTD
Other - Org Name:RIVERVIEW CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:507-625-4060
Mailing Address - Street 1:600 REED ST
Mailing Address - Street 2:SUITE 115
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-6410
Mailing Address - Country:US
Mailing Address - Phone:507-625-4060
Mailing Address - Fax:507-625-3915
Practice Address - Street 1:600 REED ST
Practice Address - Street 2:SUITE 115
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-6410
Practice Address - Country:US
Practice Address - Phone:507-625-4060
Practice Address - Fax:507-625-3915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCC00036101YP2500X
MNLP2831103TC0700X
MNLP3385103TC0700X
MS1163781041C0700X
MN395842084P0800X
1041C0700X, 103TC0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1144488OtherUCARE
MN014715000Medicaid
MNC02326OtherCMS
MNHP38978OtherHEALTH PARTNERS
MN05T96RIOtherBX/BS