Organization
HAWTHORNE FAMILY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT K VUCINOVICH MS LP (OWNER PSYCHOLOGIST)
(612) 889-4291
Entity
Organization
Contact information
Practice address
80 HAMPSHIRE AVE N, GOLDEN VALLEY, MN 55427-4923
(612) 889-4291
(763) 546-8189
Mailing address
80 HAMPSHIRE AVE N, GOLDEN VALLEY, MN 55427-4923
(612) 889-4291
(763) 546-8189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1141
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY
MN
01
—
1700954005
NPI # INDIVIDUAL
MN
01
—
330J6VU
BLUECROSS
MN
01
—
62-57935
UNITED BEHAVIORAL HEALTH
MN
Enumeration date
02/25/2007
Last updated
08/22/2020
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