Individual provider Active NPI

John Armen Desteian, JD, DPSY

  • Family Psychologist
  • Saint Paul, MN
National Provider Identifier
1174532279
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
LP0485 Issued in MN
Practice address
950 Saint Clair Ave
Saint Paul, MN 55105-3214
Phone
(651) 293-1684
Fax
(651) 293-1562
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Psychologist 103TF0000X LP0485 MN Primary
Psychoanalysis Psychologist 103TP0814X LP0485 MN
Psychologist 103T00000X LP0485 MN
Group Psychotherapy Psychologist 103TP2701X LP0485 MN

Addresses

Primary practice location

950 Saint Clair Ave
Saint Paul, MN 55105-3214

Mailing address

950 Saint Clair Ave
Saint Paul, MN 55105-3214
Phone (651) 293-1684

Other identifiers 1

IdentifierTypeStateIssuer
24123DEOtherMNBLUECROSS&BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective May 3, 2016 through May 3, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Juris Doctor

State licenses

LicenseStateTypeSpecialty
LP0485MNMDPsychoanalysis Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychoanalytic Consultants, Inc. CurrentSince Oct 4, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1174532279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 SAINT CLAIR AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053214",
            "telephone_number": "651-293-1684",
            "fax_number": "651-293-1562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 SAINT CLAIR AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053214",
            "telephone_number": "651-293-1684",
            "fax_number": "651-293-1562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEIAN",
        "first_name": "JOHN",
        "middle_name": "ARMEN",
        "name_prefix": "Dr.",
        "credential": "JD, DPSY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MN",
            "license": "LP0485",
            "primary": true
        },
        {
            "code": "103TP0814X",
            "taxonomy_group": "",
            "desc": "Psychologist, Psychoanalysis",
            "state": "MN",
            "license": "LP0485",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0485",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "MN",
            "license": "LP0485",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS&BLUE SHIELD",
            "identifier": "24123DE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.