Healthcare Provider Details

I. General information

NPI: 1437169273
Provider Name (Legal Business Name): JAMES RICHARD HEYMANS LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1360 ENERGY PARK DR SUITE 340
SAINT PAUL MN
55108-5276
US

IV. Provider business mailing address

3002 CHIPPEWA CT N
MAPLEWOOD MN
55109-1529
US

V. Phone/Fax

Practice location:
  • Phone: 651-646-8985
  • Fax: 651-646-3959
Mailing address:
  • Phone: 651-779-2383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10320
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: