MEDICARE: DR. NANCY J. ARIKIAN PHD, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	4396	MN
2	103TC1900X	Counseling Psychologist	LP4396	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366441685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NANCY J. ARIKIAN PHD, LP

Provider Business Mailing Address
First Line	:	100 S. 1ST ST.
Second Line	:	#583294
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55458-3829
Country	:	US
Telephone Number	:	612-353-5414
Fax Number	:

Provider Business Practice Location Address
First Line	:	1409 WILLOW ST STE 416
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-2269
Country	:	US
Telephone Number	:	612-353-5414
Fax Number	:	612-353-5415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2005
Last Update Date	:	07/06/2023

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