Individual
DR. JOHN MATTHEW HEALY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD LP
Contact information
Practice address
3100 W LAKE ST STE 210, MINNEAPOLIS, MN 55416-4597
(612) 925-6033
(612) 925-8496
Mailing address
3932 ALDRICH AVE SO, MINNEAPOLIS, MN 55409
(612) 296-3700
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP4567
MN
103TP2701X
Group Psychotherapy Psychologist
LP4567
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
808S6HE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
05/21/2007
Last updated
07/21/2022
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