Provider Demographics
NPI:1487786539
Name:AYD & CAVANAGH, LLC
Entity type:Organization
Organization Name:AYD & CAVANAGH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:BATKIEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-710-3671
Mailing Address - Street 1:9007 KAGAN AVE NE
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:MN
Mailing Address - Zip Code:55362-4535
Mailing Address - Country:US
Mailing Address - Phone:612-229-1234
Mailing Address - Fax:763-295-4946
Practice Address - Street 1:9007 KAGAN AVE NE
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:MN
Practice Address - Zip Code:55362-4535
Practice Address - Country:US
Practice Address - Phone:612-229-1234
Practice Address - Fax:763-295-4946
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4403101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN633K0CAOtherBCBS OF MINNESOTA
MN633K0CAOtherBCBS OF MINNESOTA