Organization
MIDWEST CLINICAL PSYCHOLOGIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER CARTEN PH.D., L.P. (OWNER)
(651) 534-4118
Entity
Organization
Contact information
Practice address
5760 ROYAL OAKS DR, SHOREVIEW, MN 55126-8490
(612) 534-4118
Mailing address
5760 ROYAL OAKS DR, SHOREVIEW, MN 55126-8490
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02522CA
BLUE CROSS BLUE SHIELD MN
MN
Enumeration date
03/07/2006
Last updated
09/11/2025
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