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Contact Information

ROBERTA J THEIS, MSE
ROBERTA J THEIS
8010 60TH AVE. NORTH
MINNEAPOLIS, MN55428
 Phone: 763-208-3784
 Fax: 763-208-3784
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
 

Clinical

1041C0700X 80 Licensed Clinical Social Worker
Indicates primary specialty

NPI Profile & details for ROBERTA J THEIS · (Female)

NPI # 1609920164
Status Active
Credentials MSE
Entity Individual
Enumeration date 01/22/2007
Last updated 04/03/2019 - About 7 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # 08691
  • MN License # LP1134
  • MN Medicaid 622252800
  • MH Other 40G39TH GROUP BLUE CROSS BLUE SHI
  • MN Other 40G40TH INDIVIDUAL BLUE CROSS BLU
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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