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NPI Code Detail

MEDICARE: HIGHLAND PARK COUNSELING ASSOCIATES LLC

MEDICARE: HIGHLAND PARK COUNSELING ASSOCIATES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1558371955
Entity Type Code : Organization
Provider Name (Legal Business Name) : HIGHLAND PARK COUNSELING ASSOCIATES LLC
Provider Business Mailing Address
First Line : 790 CLEVELAND AVE S STE 207
Second Line :
City : SAINT PAUL
State : MN
Zip : 55116-3866
Country : US
Telephone Number : 651-690-0953
Fax Number : 651-690-0968
Provider Business Practice Location Address
First Line : 774 DELAWARE AVE
Second Line :
City : SAINT PAUL
State : MN
Zip : 55107-2538
Country : US
Telephone Number : 612-269-9761
Fax Number : 612-465-4017
Authorized Official
Title or Position : PSYCHOTHERAPIST/OWNER
Name : MS. BERVEN SEARS BERVEN
Credential : LICSW
Telephone Number : 612-269-9761
Provider Enumeration Date : 08/08/2006
Last Update Date : 08/06/2025

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