TERESA A BOATMAN


Address: 11525 40th Ave N, Plymouth, MN 55441-1316
Phone: 7632344974

TERESA A BOATMAN (NPI# 1083770101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1083770101
Entity Type Individual
Full Name TERESA A BOATMAN
Credential PHD, LP
Practice Address 11525 40th Ave N
Plymouth
MN 55441-1316
Practice Telephone 7632344974
Mailing Telephone 7632344974
Enumeration Date 2007-01-01
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist LP4129 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN UBH 61-91292 01
MN BLUE CROSS BLUE SHIELD 383K7BO 01
MN HEALTH PARTNERS 108024 01

Office Location

Street Address 11525 40TH AVE N
City PLYMOUTH
State MN
Zip Code 55441-1316

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
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1083069538 Mercade Waldon Home Health Aide 3501 Xenium Lane, Plymouth, MN 55441 2016-05-03
1346645538 Phs Westhealth, Inc Skilled Nursing Facility 2775 Campus Drive North, Plymouth, MN 55441 2014-10-30
1427453125 Samuel David Fine Pharmacist 4070 Goldenrod Ln, Plymouth, MN 55441 2014-10-24
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1831498633 Comforide Transportation Services LLC Non-emergency Medical Transport (VAN) 9730 37th Pl N Suite 201, Plymouth, MN 55441 2011-03-18
1255669271 Tammy Kae Mehlhaus Physician Assistant 2855 Campus Drive, Suite 570, Plymouth, MN 55441 2009-12-02
1164758199 Stephen P. Boger, Dds, Pa Dentist 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 2009-10-27
1093908360 Endodontic Professionals Pa Plymouth Endodontics Dentist 3401 Hwy 169 N, Plymouth, MN 55441 2007-08-21
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861031056 Candi Lyn Rosenberg Psychologist 595 Forest Ave Ste 7and11a, Plymouth, MI 48170-1775 2020-01-05
1255829081 Joseph Matthew Mitchell Psychologist 44450 Pinetree Dr Ste 101, Plymouth, MI 48170-3869 2018-04-26
1164808390 Wisconsin Lutheran Child &famliy Service, Inc Psychologist 3350 Harbor Ln N, Plymouth, MN 55447-5255 2015-08-11
1972982106 Inspired By Me Psychological Wellness Psychologist 9341 N Haggerty Rd, Plymouth, MI 48170-4622 2015-05-20
1336564970 Celena N Khatib Psychologist 340 N Main St Ste 210, Plymouth, MI 48170-1250 2014-02-19
1851673537 Juvaria Javaid Psychologist 51248 Plymouth Ridge Dr, Plymouth, MI 48170-6366 2011-09-19
1770862781 Ionela Herman Psychologist 41550 E Ann Arbor Trl, Plymouth, MI 48170-4308 2011-08-08
1548404270 Jocelyn A Markowicz Psychologist 843 Penniman Ave, Plymouth, MI 48170-1757 2009-04-24
1063631695 Gail Ann Thoen Psychologist 12525 42 Avenue North, Plymouth, MN 55441-1265 2007-04-24
1508984048 Anne Marie Caldwell Psychologist 409 Plymouth Rd Ste 270, Plymouth, MI 48170-1842 2007-03-26
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City PLYMOUTH
Zip Code 55441

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Dataset Information

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.

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