DEAN THEODORE THEOPHILOS (NPI# 1497292684) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497292684 |
| Entity Type | Individual |
| Full Name | DEAN THEODORE THEOPHILOS |
| Credential | LADC |
| Practice Address |
1056 Centerville Cir Vadnais Heights MN 55127-6360 |
| Mailing Address |
1056 Centerville Cir Saint Paul MN 55127-6360 |
| Practice Telephone | 6514267771 |
| Practice Fax Number | 6514268116 |
| Mailing Telephone | 6514267771 |
| Mailing Fax Number | 6514268116 |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
303750 | MN | Behavioral Health & Social Service Providers |
| Street Address |
1056 CENTERVILLE CIR |
| City | VADNAIS HEIGHTS |
| State | MN |
| Zip Code | 55127-6360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982917415 | Jeffrey Hill | Psychologist | 1056 Centerville Cir, Vadnais Heights, MN 55127-6360 | 2010-07-26 |
| 1871108498 | Reide T Bibeau-peper | Counselor | 1056 Centerville Cir, Vadnais Heights, MN 55127-6344 | 2020-09-10 |
| 1316382427 | Judith Ryan Stein | Marriage & Family Therapist | 1056 Centerville Cir, Vadnais Heights, MN 55127-6360 | 2013-05-02 |
| 1487927067 | Parker Collins Family Mental Health, Pllc | Community/Behavioral Health | 1056 Centerville Cir, Vadnais Heights, MN 55127-6344 | 2012-02-14 |
| 1548539042 | Soo Y Moon | Marriage & Family Therapist | 1056 Centerville Cir, Vadnais Heights, MN 55127-6360 | 2011-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013514058 | Taylor Nessa Draves | Behavior Technician | 1011 Meadowlamds Dr, White Bear Lake, MN 55127 | 2020-10-02 |
| 1578104196 | Patricia Lynn Bina | Technician | 3677 Centerville Rd, Vadnais Heights, MN 55127 | 2019-10-04 |
| 1023538469 | Dignicare Senior Management of Vadnais | Assisted Living Facility | 580 Liberty Way, Vadnais Heights, MN 55127 | 2017-06-27 |
| 1548610207 | Golden Elderly Care Suites LLC | Assisted Living Facility | 4624 Stoddart Circle, White Bear Lake, MN 55127 | 2016-06-14 |
| 1811018203 | Adam F Curtis | Dentist | 925 East County Road E, Suite 185, Vadnais Heights, MN 55127 | 2007-04-03 |
| 1134215700 | Phoenix Residence, Inc. | Intermediate Care Facility, Mentally Retarded | 785 E County Road E, Vadnais Heights, NE 55127 | 2006-10-04 |
| 1861404790 | Gerald James Pease | Optometrist | 850 East Co Rd E, Walmart Vision Center, Vadnais Heights, MN 55127 | 2006-08-12 |
| 1235629395 | Suite Living Senior Management | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55127 | 2018-05-15 |
| 1760986624 | Diandra Shakira Williams | Physician Assistant | 3580 Arcade St, Vadnais Heights, MN 55127 | 2018-03-23 |
| 1811370729 | Sonya L Knudson | Psychologist | 4444 Centerville Rd Ste 235, White Bear Lake, MN 55127 | 2015-07-09 |
| Find all providers in zip 55127 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1134720212 | Rachel Renee Przekwas | Counselor | 216 Center St W Ste 101, Roseau, MN 56751-1494 | 2020-11-04 |
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1215537477 | Hannah Mae Kidder | Counselor | 1605 Welcome Ave N, Golden Valley, MN 55422-4429 | 2020-10-27 |
| 1649879339 | Jordan Lowe | Counselor | 4615 Grand Ave Ste 300, Duluth, MN 55807-2749 | 2020-10-22 |
| 1417556762 | Jacob R Poppinga | Counselor | 13045 Falcon Dr Ste 7404th, Baxter, MN 56425-4201 | 2020-10-19 |
| 1598362014 | Jeremy Krekula | Counselor | 102 Main St N Ste 100, Stewartville, MN 55976-2608 | 2020-10-07 |
| 1235736786 | Catherine Ann Jaksha | Counselor | 1180 Cushing Cir Apt 217, Saint Paul, MN 55108-5016 | 2020-10-07 |
| 1952908881 | Sutton Outpatient Services, LLC | Counselor | 1700 Livingston Ave Ste 120, West St Paul, MN 55118-5938 | 2020-10-05 |
| 1750998423 | Recovery Alliance Duluth | Counselor | 206 W 4th St Ste 203, Duluth, MN 55806-2659 | 2020-09-28 |
| Find all providers with the same taxonomy | ||||
| City | VADNAIS HEIGHTS |
| Zip Code | 55127 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.