Healthcare Provider Details

I. General information

NPI: 1306814009
Provider Name (Legal Business Name): STEVEN W PELTIER PH.D., L.P., L.M.F.T
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 RAMSEY ST RAMSEY PROFESSIONAL BLDG.
SAINT PAUL MN
55102-2323
US

IV. Provider business mailing address

761 LINCOLN AVE
SAINT PAUL MN
55105-3348
US

V. Phone/Fax

Practice location:
  • Phone: 651-293-0811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP1278
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberC0741
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP1278
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: