NPIMap

Organization Active NPI

MN Couple Therapy Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roseville, MN
National Provider Identifier
1770912271
Registry record updated Nov 5, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
1357 Issued in MN
Legal business name
MN COUPLE THERAPY CENTER
Practice address
1611 County Road B W
Suite 303
Roseville, MN 55113-5021
Phone
(651) 340-4597
Fax
(651) 340-4597
NPI assigned
Nov 5, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2013

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

Authorized official

Name
Dr. Kurt A Wical, PHDNPI 1124181656
Title
Director
Phone
(651) 340-4597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 1357 MN Primary

Addresses

Primary practice location

1611 County Road B W
Suite 303
Roseville, MN 55113-5021

Mailing address

1611 County Road B W
Suite 303
Roseville, MN 55113-5021
Phone (651) 340-4597

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383609600000",
    "number": "1770912271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W",
            "address_2": "SUITE 303",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135021",
            "telephone_number": "651-340-4597",
            "fax_number": "651-340-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 COUNTY ROAD B W",
            "address_2": "SUITE 303",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551135021",
            "telephone_number": "651-340-4597",
            "fax_number": "651-340-4597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MN COUPLE THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-05",
        "last_updated": "2013-11-05",
        "status": "A",
        "authorized_official_last_name": "WICAL",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "651-340-4597",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "1357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.