Provider Demographics
NPI:1043375041
Name:BEHAVIORAL AND COUNSELING SERVICES OF MINNESOTA
Entity type:Organization
Organization Name:BEHAVIORAL AND COUNSELING SERVICES OF MINNESOTA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:JEANNE
Authorized Official - Last Name:VAN ZILE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:612-558-4318
Mailing Address - Street 1:1409 WILLOW ST
Mailing Address - Street 2:SUITE 520
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55403-2269
Mailing Address - Country:US
Mailing Address - Phone:612-558-4318
Mailing Address - Fax:612-871-5399
Practice Address - Street 1:1409 WILLOW ST
Practice Address - Street 2:SUITE 520
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55403-2269
Practice Address - Country:US
Practice Address - Phone:612-558-4318
Practice Address - Fax:612-871-5399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLPO319103T00000X, 103TB0200X
MNLP0319103T00000X, 103TA0400X, 103TC1900X, 103TF0000X
MSLP0319103TC0700X, 103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
Not Answered103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamilyGroup - Multi-Specialty
Not Answered103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN73211Medicare UPIN
MN2H158VAMedicare UPIN