Provider Demographics
NPI:1619434867
Name:WINSTON BEHAVIORAL HEALTHCARE
Entity Type:Organization
Organization Name:WINSTON BEHAVIORAL HEALTHCARE
Other - Org Name:WINSTON BEHAVIORAL HEALTHCARE, PSC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WINSTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:651-689-3007
Mailing Address - Street 1:3282 YORK ALCOVE
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2417
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:724 BIELENBERG DR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-2620
Practice Address - Country:US
Practice Address - Phone:651-274-1006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty