INTERNAL REVOLUTION COUNSELING AND CONSULTING, L.L.C.


Address: 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105
Phone: 6127877583

INTERNAL REVOLUTION COUNSELING AND CONSULTING, L.L.C. (NPI# 1679020226) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1679020226
Entity Type Organization
Organization Name INTERNAL REVOLUTION COUNSELING AND CONSULTING, L.L.C.
Practice Address 1123 Grand Avenue
Suite 201
Saint Paul
MN 55105
Mailing Address 3125 37th Ave South
Minneapolis
MN 55406-2134
Practice Telephone 6127877583
Mailing Telephone 6127877583
Enumeration Date 2016-09-01
Last Update Date 2016-09-01
Authorized Official Name DR. ANESH PATEL (PSYCHOLOGIST)
Authorized Official Telephone 6127877583
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC1900X Psychologist
Specialization: Counseling
LP5711 MN Behavioral Health & Social Service Providers

Office Location

Street Address 1123 GRAND AVENUE
SUITE 201
City SAINT PAUL
State MN
Zip Code 55105

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Taxonomy Information

Taxonomy Code 103TC1900X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Counseling

Taxonomy Definition

Definition to come...

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City SAINT PAUL
Zip Code 55105

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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