Healthcare Provider Details

I. General information

NPI: 1497445746
Provider Name (Legal Business Name): PAUL TIMOTHY BEBUS LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2023
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7601 WAYZATA BLVD
MINNEAPOLIS MN
55426-1626
US

IV. Provider business mailing address

7601 WAYZATA BLVD
MINNEAPOLIS MN
55426-1626
US

V. Phone/Fax

Practice location:
  • Phone: 952-913-5277
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5461
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: