Healthcare Provider Details

I. General information

NPI: 1588739643
Provider Name (Legal Business Name): RICHARD JULIAN STUDER MA, LMFT, LP, LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1919 UNIVERSITY AVE W G6
SAINT PAUL MN
55104-3453
US

IV. Provider business mailing address

1516 W LAKE ST SUITE 2000S
MINNEAPOLIS MN
55408-2554
US

V. Phone/Fax

Practice location:
  • Phone: 651-641-1555
  • Fax: 651-641-0340
Mailing address:
  • Phone: 612-381-2494
  • Fax: 612-381-2494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberLP1132
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW 6524
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLMFT 109
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: