DR. ROY JOHN SUTHERLAND (NPI# 1073820379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073820379 |
| Entity Type | Individual |
| Full Name | DR. ROY JOHN SUTHERLAND |
| Credential | PHD, ABPP,LADC,MHA |
| Practice Address |
550 Osborne Rd Ne # Mr 52790 Fridley MN 55432-2718 |
| Practice Telephone | 7632364375 |
| Mailing Telephone | 7632364375 |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2018-03-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP5295 | MN | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
LP5295 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1073820379 | 05 |
| Street Address |
550 OSBORNE RD NE # MR 52790 |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-2718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| 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 |
|---|---|---|---|---|
| 1649613837 | Aria Counseling, Assessment and Mediation Centers, P.l.l.c. | Psychologist | 7260 University Ave Ne Ste 235, Fridley, MN 55432-3141 | 2013-04-08 |
| 1316965452 | Sandra Crossett | Psychologist | 7362 University Ave Ne Ste 302, Fridley, MN 55432-3150 | 2006-07-17 |
| 1669435368 | Mary Sue Zaudtke | Psychologist | 1250 Moore Lake Dr E Ste 220, Fridley, MN 55432-5135 | 2006-04-11 |
| 1033320486 | Kathrine Linn Brathen | Psychologist | 7954 University Ave Ne, Fridley, MN 55432-1860 | 2007-05-25 |
| 1700938081 | Judy Lynn Heimlich | Psychologist | 7590 Lyric Ln Ne, Fridley, MN 55432-3251 | 2007-01-17 |
| 1467503185 | Mark Alan Meyer | Psychologist | 6401 University Ave Ne, Suite 205, Fridley, MN 55432-4341 | 2007-01-16 |
| 1306911821 | Clinton Vanlith | Psychologist | 500 Osborne Rd Ne Ste 255, Fridley, MN 55432-2768 | 2006-11-21 |
| 1023199676 | Family Visions, Inc. | Psychologist | 7362 University Ave Ne Ste 302, Fridley, MN 55432-3150 | 2006-10-18 |
| 1225138084 | Thomas Edward Harbaugh | Psychologist | 7362 University Ave Ne, Suite 209, Fridley, MN 55432-3142 | 2006-09-22 |
| 1689772998 | Sandra Lee Shearer | Psychologist | 7362 University Ave Ne, Suite 209, Fridley, MN 55432-3142 | 2006-09-20 |
| Find all providers in FRIDLEY | ||||
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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.