JAY ROBERT PHILLIPPI (NPI# 1053692020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053692020 |
| Entity Type | Individual |
| Full Name | JAY ROBERT PHILLIPPI |
| Credential | PH.D. |
| Practice Address |
112 University Dr N Ste 300 Fargo ND 58102 |
| Mailing Address |
464 Clearview Ct Moorhead MN 56560-6800 |
| Practice Telephone | 7018663641 |
| Practice Fax Number | 7016601071 |
| Mailing Telephone | 7018663641 |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2018-08-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| Street Address |
112 UNIVERSITY DR N STE 300 |
| City | FARGO |
| State | ND |
| Zip Code | 58102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306149323 | Ashley Lynn Stielow | Counselor | 112 University Dr N Ste 300, Fargo, ND 58102-4661 | 2010-12-14 |
| 1174011126 | Inner Canvas Counseling, Pllc | Counselor | 112 University Dr N Ste 300, Fargo, ND 58102-4661 | 2018-04-25 |
| 1316475908 | Jelisa Phillippi | Specialist | 112 University Dr N Ste 300, Fargo, ND 58102-4661 | 2017-05-26 |
| 1427446798 | Positive Psychological Initiatives LLC | Psychologist | 112 University Dr N Ste 300, Fargo, ND 58102 | 2015-01-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780285924 | Shelley Dene Townsend-hansen | Dentist | 1017 Broadway N, Fargo, ND 58102 | 2020-11-04 |
| 1275190779 | Anthony Joseph Duncan | Student in an Organized Health Care Education/Training Program | 1919 Elm Streent North, Fargo, ND 58102 | 2019-05-21 |
| 1003472317 | Sadie Marie Nelson | Nurse Practitioner | Sanford Broadway Clinic, 801 North Broadway, Fargo, ND 58102 | 2019-05-13 |
| 1124523576 | Christopher Peroutka | Specialist/Technologist | 1300 17th Ave N, Fargo, ND 58102 | 2018-03-28 |
| 1205331873 | Nathan Koens | Specialist/Technologist | 1300 17th Avenue North, Fargo, ND 58102 | 2018-03-27 |
| 1376063370 | Abby Nicole Fredrickson | Student in an Organized Health Care Education/Training Program | 1919 Elm Street North, Fargo, ND 58102 | 2017-06-21 |
| 1780118331 | Stephanie Melquist | Internal Medicine | Internal Medicine Resident Clinic, 801 N Broadway, Fargo, ND 58102 | 2017-04-19 |
| 1104215623 | Justin Lervik | Social Worker | 211 Elm St. N, 122, Fargo, ND 58102 | 2015-01-21 |
| 1770919441 | Courtney Ann Simanski | Speech-Language Pathologist | 415 4th St. N., Fargo, ND 58102 | 2013-09-25 |
| 1821431206 | Lanell Staroba | Pharmacist | 706 D 38th St, Fargo, ND 58102 | 2013-04-16 |
| Find all providers in zip 58102 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366067084 | Minela Zornic | Psychologist | 204 24th St S Apt 210, Fargo, ND 58103-1350 | 2020-06-09 |
| 1518240332 | Erica R Hoff | Psychologist | 505 40th St. S., Suite 505a, Fargo, ND 58103 | 2011-09-28 |
| 1538399019 | Kristilynn Cedars | Psychologist | 5225 23rd Ave S Route 4712, Fargo, ND 58122-4712 | 2009-07-20 |
| 1982707543 | David Jerome Hartson | Psychologist | 1517 32nd Ave S, Fargo, ND 58103-5905 | 2006-09-07 |
| 1255449989 | Sara D Quam | Psychologist | 3220 18th St S, Ste 4, Fargo, ND 58104-6564 | 2006-08-25 |
| 1114949773 | Eileen Stone | Psychologist | 1308 23rd St S, Fargo, ND 58103 | 2006-07-24 |
| 1215982319 | Jackson William Lind | Psychologist | 100 4th St. S #302, Fargo, ND 58103 | 2006-05-24 |
| 1720622822 | Nicole Marie Justice | Psychologist | 2101 Elm St N, Fargo, ND 58102-2417 | 2019-10-31 |
| 1386186211 | Katie Nylander | Psychologist | 3401 45th St S, Fargo, ND 58104 | 2016-11-09 |
| 1770930273 | Megan L Spencer | Psychologist | 1702 University Dr S, Fargo, ND 58103-4940 | 2016-05-16 |
| Find all providers in FARGO | ||||
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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.