Organization
PSYCHOANALYTIC CONSULTANTS, INC.
Active
Other names
PCI
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN A DESTEIAN DPSY (OWNER)
(651) 293-1684
Entity
Organization
Contact information
Practice address
950 SAINT CLAIR AVE, SAINT PAUL, MN 55105-3214
(651) 293-1684
(651) 293-1562
Mailing address
950 SAINT CLAIR AVE, SAINT PAUL, MN 55105-3214
(651) 293-1684
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICSW2014
LICSW
MN
01
—
LPO485
LP
MN
Enumeration date
10/01/2020
Last updated
10/01/2020
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