Provider Demographics
NPI:1649613837
Name:ARIA COUNSELING ASSESSMENT AND MEDIATION CENTERS PLLC
Entity type:Organization
Organization Name:ARIA COUNSELING ASSESSMENT AND MEDIATION CENTERS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:MCLELLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LP
Authorized Official - Phone:763-572-2605
Mailing Address - Street 1:7260 UNIVERSITY AVE NE STE 235
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-3141
Mailing Address - Country:US
Mailing Address - Phone:763-572-2605
Mailing Address - Fax:
Practice Address - Street 1:7260 UNIVERSITY AVE NE STE 235
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-3141
Practice Address - Country:US
Practice Address - Phone:763-572-2605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN0295103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty