Healthcare Provider Details

I. General information

NPI: 1043375041
Provider Name (Legal Business Name): BEHAVIORAL AND COUNSELING SERVICES OF MINNESOTA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1409 WILLOW ST SUITE 520
MINNEAPOLIS MN
55403-2269
US

IV. Provider business mailing address

1409 WILLOW ST SUITE 520
MINNEAPOLIS MN
55403-2269
US

V. Phone/Fax

Practice location:
  • Phone: 612-558-4318
  • Fax: 612-871-5399
Mailing address:
  • Phone: 612-558-4318
  • Fax: 612-871-5399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLPO319
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberLP0319
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberLPO319
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP0319
License Number StateMS
# 5
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLP0319
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberLP0319
License Number StateMN
# 7
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License NumberLP0319
License Number StateMS
# 8
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP0319
License Number StateMN

VIII. Authorized Official

Name: NANCY JEANNE VAN ZILE
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 612-558-4318