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NPI Code Detail

MEDICARE: DBT ASSOCIATES

MEDICARE: DBT ASSOCIATES
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
2103T00000XPsychologist
3101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
207F28DIOTHERMNBLUE CROSS
38G624DIOTHERMNBLUE CROSS

General Provider Information

NPI Number : 1639104193
Entity Type Code : Organization
Provider Name (Legal Business Name) : DBT ASSOCIATES
Provider Business Mailing Address
First Line : 7362 UNIVERSITY AVE NE
Second Line : SUITE 101
City : FRIDLEY
State : MN
Zip : 55432-3142
Country : US
Telephone Number : 763-503-3981
Fax Number : 763-503-3981
Provider Business Practice Location Address
First Line : 7362 UNIVERSITY AVE NE
Second Line : SUITE 101
City : FRIDLEY
State : MN
Zip : 55432-3142
Country : US
Telephone Number : 763-503-3981
Fax Number : 763-503-3981
Authorized Official
Title or Position : MANAGING PARTNER
Name : ANNE MARIE GRESHAM
Credential : ARNP
Telephone Number : 763-503-3981
Provider Enumeration Date : 07/12/2006
Last Update Date : 05/13/2008

Similar Medicare Providers

1568489649 — MRS. CHRISTINE C. KVIDERA MSW, LICSW
Practice Location Address:
7362 UNIVERSITY AVE NE , SUITE 101
FRIDLEY, MN
55432-3142
Practice Phone: 763-503-3981
Practice Fax: 763-503-3981
1396763066 — KAMRAN AFZAL M.D.
Practice Location Address:
7362 UNIVERSITY AVE NE , SUITE 201
FRIDLEY, MN
55432-3142
Practice Phone: 612-789-8346
Practice Fax: 763-432-6780
1407864812 — MRS. KRISTEN MARIE FRITSINGER MSW, LICSW
Practice Location Address:
7362 UNIVERSITY AVE NE , SUITE 101
FRIDLEY, MN
55432-3142
Practice Phone: 763-503-3981
Practice Fax: 763-503-3981
1336152644 — PAUL CARLETON RYALS LICSW
Practice Location Address:
7362 UNIVERSITY AVE NE , SUITE 101
FRIDLEY, MN
55432-3142
Practice Phone: 763-503-3981
Practice Fax:
1598874703 — MS. SUSAN JANE VENZKE SOCIAL WORKER
Practice Location Address:
7362 UNIVERSITY AVE NE , SUITE 101
FRIDLEY, MN
55432-3142
Practice Phone: 763-503-3981
Practice Fax: 763-503-3981
1174634992 — JAMES MULLER POWELL L.I.C.S.W.
Practice Location Address:
7362 UNIVERSITY AVE NE , SUITE 101
FRIDLEY, MN
55432-3142
Practice Phone: 763-503-3981
Practice Fax: 763-503-3981

Directions to “DBT ASSOCIATES ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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