Provider Demographics
NPI:1942630728
Name:MULTICULTURAL PSYCHOTHERAPY AND CONSULTING SERVICES LTD
Entity Type:Organization
Organization Name:MULTICULTURAL PSYCHOTHERAPY AND CONSULTING SERVICES LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIA
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOPEZ-PETROVICH
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:612-702-3483
Mailing Address - Street 1:4471 HIGHWAY 10
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55112-1952
Mailing Address - Country:US
Mailing Address - Phone:612-702-3483
Mailing Address - Fax:651-633-1219
Practice Address - Street 1:3133 HENNEPIN AVE SOUTH
Practice Address - Street 2:(LOWER LEVEL)
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2620
Practice Address - Country:US
Practice Address - Phone:612-702-3483
Practice Address - Fax:651-633-1219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-15
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty