Provider Demographics
NPI:1386751865
Name:STEHLIN LIC PSYCHOL, ROBERT J.
Entity type:Organization
Organization Name:STEHLIN LIC PSYCHOL, ROBERT J.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:STEHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LP
Authorized Official - Phone:218-263-6215
Mailing Address - Street 1:3920 13TH AVE E
Mailing Address - Street 2:SUITE 6
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-3675
Mailing Address - Country:US
Mailing Address - Phone:218-263-7540
Mailing Address - Fax:866-732-0699
Practice Address - Street 1:530 E HOWARD ST
Practice Address - Street 2:SUITE 106
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-1753
Practice Address - Country:US
Practice Address - Phone:218-263-6215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP 2035103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN69110STOtherBCBS