Individual
DEAN THEODORE THEOPHILOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LCPC, LADC
Contact information
Practice address
2324 UNIVERSITY AVE W STE 100, SAINT PAUL, MN 55114-1854
(651) 641-1009
(651) 789-5677
Mailing address
2324 UNIVERSITY AVE W STE 100, SAINT PAUL, MN 55114-1854
(651) 641-1009
(651) 789-5677
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303750
MN
101YM0800X
Mental Health Counselor
180.012732
IL
101YM0800X
Mental Health Counselor
Primary
CC01465
MN
Other
Enumeration date
01/25/2017
Last updated
07/13/2022
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