| Vaughn R Jefferson Psyd Mdiv Lp Llc | |
|
1030 West County Road E Ste 260 Shoreview MN 55126 | |
| (651) 483-1333 | |
| (651) 789-3088 |
| Full Name | Vaughn R Jefferson Psyd Mdiv Lp Llc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1030 West County Road E, Shoreview, Minnesota |
| Authorized Official Name and Position | Vaughn Robert Jefferson (PRESIDENT) |
| Authorized Official Contact | 6514831333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vaughn R Jefferson Psyd Mdiv Lp Llc 1030 West County Road E Ste 260 Shoreview MN 55126 Ph: (651) 483-1333 | Vaughn R Jefferson Psyd Mdiv Lp Llc 1030 West County Road E Ste 260 Shoreview MN 55126 Ph: (651) 483-1333 |
| NPI Number | 1801036272 |
|---|---|
| Provider Enumeration Date | 02/25/2009 |
| Last Update Date | 11/06/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801036272 | NPI | - | NPPES |
| 688750300 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | LP 1666 (Minnesota) | Primary |
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Elaine K Johnson Ma Lp Ladc Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 521 Tanglewood Dr, Shoreview, MN 55126 Phone: 612-801-5826 Fax: 651-490-5215 | |
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Keystone Counseling And Consulting Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4700 Lexington Ave N Ste B, Shoreview, MN 55126 Phone: 651-421-0815 | |
Woodcrest Counseling, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 521 Tanglewood Dr, Shoreview, MN 55126 Phone: 763-753-1785 Fax: 763-753-1753 | |
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