Healthcare Provider Details

I. General information

NPI: 1518162684
Provider Name (Legal Business Name): PARTNERS IN HEALING OF MINNEAPOLIS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2007
Last Update Date: 01/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10505 WAYZATA BLVD., SUITE #200
MINNETONKA MN
55305-5507
US

IV. Provider business mailing address

10505 WAYZATA BLVD., SUITE #200
MINNETONKA MN
55305-5507
US

V. Phone/Fax

Practice location:
  • Phone: 763-546-5797
  • Fax: 763-546-5754
Mailing address:
  • Phone: 763-546-5797
  • Fax: 763-546-5754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number17268
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberLP1585
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP1585
License Number StateMN
# 4
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP4786
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberLP4786
License Number StateMN
# 6
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberLP4786
License Number StateMN
# 7
Primary TaxonomyN
Taxonomy Code103TF0000X
TaxonomyFamily Psychologist
License NumberLP4786
License Number StateMN
# 8
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberLP4786
License Number StateMN
# 9
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17268
License Number StateMN
# 10
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number917
License Number StateMN
# 11
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1140
License Number StateMN
# 12
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP1585
License Number StateMN

VIII. Authorized Official

Name: DR. DAVID S ALTER
Title or Position: OWNER
Credential: PHD, LP
Phone: 763-546-5797