Organization
HARBOR CITY PSYCHOLOGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL GOOSSENS (PRESIDENT)
(218) 722-4058
Entity
Organization
Contact information
Practice address
324 W SUPERIOR ST STE 730, DULUTH, MN 55802-1720
(218) 722-4058
(218) 722-4059
Mailing address
324 W SUPERIOR ST STE 730, DULUTH, MN 55802-1720
(218) 722-4058
(218) 722-4059
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP2592
MN
103TC0700X
Clinical Psychologist
LP4732
MN
1041C0700X
Clinical Social Worker
19635
MN
1041C0700X
Clinical Social Worker
6443
MN
1041C0700X
Clinical Social Worker
7560
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038158600
—
MN
01
—
BCBS385R5HA
2
MN
Enumeration date
06/26/2006
Last updated
04/09/2021
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