Organization · Type 2 NPI

Tubman

Mental Health Clinic/Center (Including Community Mental Health Center) · Minneapolis, MN

NPI number 1376655159 Active

Practice location

4432 Chicago Avenue South
Minneapolis, MN 55407

Fax (612) 870-2428

Specialties and licenses

Taxonomy	Code	License
Mental Health Clinic/Center (Including Community Mental Health Center)	261QM0801X	None listed
Mental Health Clinic/Center (Including Community Mental Health Center) Primary	261QM0801X	8004872MHC (MN)

Mental Health Clinic/Center (Including Community Mental Health Center): Definition to come...

2 other providers at this address

Catherine Maria Strub, MSW LICSWClinical Social Worker Minneapolis, MN NPI 1760594535
Kimberly Paulette Sersland Brady, MA, LP, LPCCPsychologist Minneapolis, MN NPI 1952432130

Other mental health clinic/center (including community mental health center) providers in Minneapolis

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NPI record

NPI: 1376655159
Entity type: Organization (Type 2)
Issued: Aug 31, 2006
Last updated: Nov 4, 2008
Status: Active

Other names

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Tubman Family Alliance & Chrysalis A Center for Women Inc · former legal business name

Authorized official

Beverly Dusso
Executive Director
(612) 767-6690

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1376655159

Tubman's National Provider Identifier is 1376655159, issued on Aug 31, 2006. The primary taxonomy on file is Mental Health Clinic/Center (Including Community Mental Health Center) (261QM0801X), and the practice location is in Minneapolis, MN. The record was last updated on Nov 4, 2008.