Rebecca Jane Anderson, MA,LP
Individual provider Active NPI Counseling Psychologist · Saint Louis Park, MN
NPI 1104038660 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104038660
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- LP3901 (MN)
- Practice address
- 5009 Excelsior Blvd Ste 134
Saint Louis Park, MN 55416-3049 - Phone
- (763) 591-1845
- NPI assigned
- May 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3901 | MN | MD | Counseling Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP3901 | MN | Yes |
Addresses
Primary practice location
5009 Excelsior Blvd Ste 134
Saint Louis Park, MN 55416-3049
Mailing address
501 Theodore Wirth Pkwy Apt 312
Golden Valley, MN 55422-5341
Phone (763) 591-1845
Other providers in Saint Louis Park, MN
- Lucinda Jo Anderson
- Mindy Anderson
- Molly Ann Anderson
- Paul Joseph Anderson II
- Rachel Anderson
- Rochelle Anderson
- Sean E Anderson
- Shayla Anderson
- Todd A Anderson
- Trent Anderson
All providers in Saint Louis Park, MN · Counseling Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.