Provider Demographics
NPI:1609939198
Name:BEYZAVI, PARI (PHD, LMFT)
Entity Type:Individual
Prefix:DR
First Name:PARI
Middle Name:
Last Name:BEYZAVI
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4205 LANCASTER LN N STE 102
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-1702
Mailing Address - Country:US
Mailing Address - Phone:763-551-1850
Mailing Address - Fax:763-551-1851
Practice Address - Street 1:4205 LANCASTER LN N STE 102
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-1702
Practice Address - Country:US
Practice Address - Phone:763-551-1850
Practice Address - Fax:763-551-1851
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN881106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN709660700OtherMA PROVIDER NUMBER
MN6607504OtherMN ID NUMBER
MN709660700OtherMA PROVIDER NUMBER