Organization
MINNEAPOLIS CLINICAL ASSOCIATES IN PSYCHIATRY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN MORK (OFFICE MANAGER)
(763) 512-1090
Entity
Organization
Contact information
Practice address
2960 WINNETKA AVE N, STE 208, CRYSTAL, MN 55427-2853
(763) 512-1090
Mailing address
2960 WINNETKA AVE N, STE 208, CRYSTAL, MN 55427-2853
(763) 512-1090
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
109039
U-CARE MN
MN
01
—
11618
BCBS
MN
05
—
130512300
—
MN
01
—
1814
UNITED HEALTHCARE
MN
01
—
7079249
AETNA
MN
Enumeration date
10/26/2005
Last updated
04/20/2011
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