Organization
PSYCHOLOGY & REHABILITATION SERVICES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. NATHANIEL STEWART JR. M.A.,L.P., Q.R.C,CRC (CEO/LICENSED PSYCHOLOGIST)
(651) 645-0645
Entity
Organization
Contact information
Practice address
1535 LAUREL AVE, SAINT PAUL, MN 55104-6739
(651) 645-0645
(651) 645-0630
Mailing address
1535 LAUREL AVE, SAINT PAUL, MN 55104-6739
(651) 645-0645
(651) 645-0630
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LP2279
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111770
UCARE
MN
01
—
27815ST
BCBS
MN
01
—
6273761
MEDICA
MN
01
—
666348600
MINNESOTA HEALTH CARE PROGRAMS
MN
01
—
86656ST
BCBS
MN
Enumeration date
06/17/2009
Last updated
06/17/2009
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