Organization
STONE ARCH PSYCHOLOGY AND HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN GUSTAFSON PSD. LP. (PSYCHOLOGIST)
(612) 886-2524
Entity
Organization
Contact information
Practice address
219 MAIN ST SE STE 400, MINNEAPOLIS, MN 55414
(612) 886-2524
(612) 886-2538
Mailing address
219 MAIN ST SE STE 400, MINNEAPOLIS, MN 55414-2151
(612) 886-2524
(612) 886-2538
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP3594
MN
103TA0700X
Adult Development & Aging Psychologist
LP3594
MN
103TB0200X
Cognitive & Behavioral Psychologist
LP3594
MN
103TC0700X
Clinical Psychologist
Primary
LP3594
MN
103TC1900X
Counseling Psychologist
LP3594
MN
103TC2200X
Clinical Child & Adolescent Psychologist
LP3594
MN
103TS0200X
School Psychologist
LP3594
MN
Other
Enumeration date
12/30/2011
Last updated
06/11/2018
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