Healthcare Provider Details

I. General information

NPI: 1831261775
Provider Name (Legal Business Name): PSYCHIATRIC CONSULTING PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 DREW AVE S
EDINA MN
55435
US

IV. Provider business mailing address

6525 DREW AVE S
EDINA MN
55435
US

V. Phone/Fax

Practice location:
  • Phone: 952-920-6748
  • Fax: 952-920-3863
Mailing address:
  • Phone: 952-920-6748
  • Fax: 952-920-3863

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number43914
License Number StateMN

VIII. Authorized Official

Name: PAUL A ERICKSON
Title or Position: PRESIDENT OWNER
Credential: MD
Phone: 952-920-6748