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Contact Information

PHILIP PSYCHOLOGICAL CLINIC
510 SIBLEY STREET
SUITE 200
MANKATO, MN56001
 Phone: 207-345-5049
 Fax: 507-345-5049
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for PHILIP PSYCHOLOGICAL CLINIC

NPI Number 1326216169
LBN Legal business name PHILIP PSYCHOLOGICAL CLINIC
Authorized official PONVELIL PHILIP - (OWNER DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/14/2008
Last updated 02/14/2008 - About 18 years ago
Identifiers
MN License # LP2258
MN Other 41516PH BCBS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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