Paul John Dousi, PHD, LMFT

Individual provider Active NPI Marriage & Family Therapist · Champlin, MN

NPI 1245358076 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1245358076
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
1227 (MN)
Practice address
6300 117TH Ave N
Champlin, MN 55316-2402
Phone
(763) 458-0154
Fax
(763) 427-5688
NPI assigned
Mar 27, 2007
Sex
Male
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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1227MNMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1227 MN Yes

Addresses

Primary practice location

6300 117TH Ave N
Champlin, MN 55316-2402

Mailing address

6300 117TH Ave N
Champlin, MN 55316-2402
Phone (763) 458-0154

Other providers in Champlin, MN

All providers in Champlin, MN · Marriage & Family Therapist in Minnesota

Sources for this page

Verify at the official NPI Registry.