Doctor Name: | DOUGLAS PELCAK |
NPI Number: | 1457572638 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA |
License Number: | |
Business Practice Address: | 3919 W 44th St 200 Edina, MN - 554241032 |
Business Phone Number: | 9529340678 |
Business Fax Number: | |
Mailing Address: | 9770 Garrison Way, EDEN PRAIRIE |
State: | MN |
Postal Code: | 553473039 |
Phone Number: | 6129984313 |
Fax Number: | 9529885199 |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |