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General NPI Number Information
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NPI Number | 1619868338
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Entity Type | Organization
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Legal Business Name | GROUP THERAPY CENTRAL
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 2423 VALLEY DR
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City | NORTHFIELD
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State | MN
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Zip | 55057-3224
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Country | US
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Telephone | 507-581-5920
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Fax |
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Provider Business Mailing Address
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Address Line | 2423 VALLEY DR
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City | NORTHFIELD
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State | MN
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Zip | 55057-3224
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Country | US
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Telephone | 507-581-5920
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Fax |
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Authorized Official
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Title or Position | OWNER, PSYCHOLOGIST
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Name | NATHANIEL PAGE
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Credential | PHD
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Telephone | 507-581-5920
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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