NPI 1043757925 · live from the CMS NPI Registry
Acacia Psychological Corporation
Psychologist, Clinical in Minneapolis, MN. National Provider Identifier 1043757925, active.
NPI record
| NPI | 1043757925 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Psychologist, Clinical 103TC0700X |
| Practice location | 2720 University Ave Se, Unit B, Minneapolis, MN 55414 |
| Practice phone | 805-399-2511 |
| Mailing address | 948 Embarcadero Del Norte, Goleta, CA 93117 |
| Enumerated | January 30, 2017 |
| Last updated | March 14, 2017 |
| Authorized official | Brett Donnelly, Co-Owner/Ceo |
| Other names | Acacia Counseling & Wellness |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional | 101YP2500X | CC01316 (MN) |
| Psychologist, Clinical primary | 103TC0700X | GL0058 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.