Provider Demographics
NPI:1154583425
Name:RAYE MCPHILLIPS EYRICH, PH.D., L.P., LLC
Entity type:Organization
Organization Name:RAYE MCPHILLIPS EYRICH, PH.D., L.P., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYE
Authorized Official - Middle Name:MCPHILLIPS
Authorized Official - Last Name:EYRICH
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:612-203-8660
Mailing Address - Street 1:4721 HARRIET AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55419-5433
Mailing Address - Country:US
Mailing Address - Phone:612-203-8660
Mailing Address - Fax:612-659-1906
Practice Address - Street 1:825 NICOLLET MALL STE 612
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55402-2612
Practice Address - Country:US
Practice Address - Phone:612-203-8660
Practice Address - Fax:612-659-1906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP0348261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
6164189OtherMEDICA
036M6EYOtherBLUECROSS BLUESHIELD OF MINNESOTA
MN063709200Medicaid
26606OtherHEALTHPARTNERS
594721018854OtherPREFERRED ONE PPO
594721018854OtherPREFERRED ONE PPO