HOLLY ANN CRANDALL (NPI# 1124534508) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124534508 |
| Entity Type | Individual |
| Full Name | HOLLY ANN CRANDALL |
| Credential | LADC |
| Practice Address |
2360 North Broadway Rochester MN 55906 |
| Mailing Address |
2360 N Broadway Rochester MN 55906-4065 |
| Practice Telephone | 5072820142 |
| Practice Fax Number | 5072826261 |
| Mailing Telephone | 5072820142 |
| Mailing Fax Number | 5072826261 |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TA0400X |
Psychologist Specialization: Addiction (Substance Use Disorder) |
304375 | MN | Behavioral Health & Social Service Providers |
| Street Address |
2360 NORTH BROADWAY |
| City | ROCHESTER |
| State | MN |
| Zip Code | 55906 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518173038 | Metro Treatment of Minnesota Lp | Clinic/Center | 2360 North Broadway, Rochester, MN 55906-4065 | 2007-05-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912472440 | Carole Ellen Jenson | Nurse Practitioner | Rochester Clinic, 3070 Wellner Drive Ne, Rochester, MN 55906 | 2018-10-11 |
| 1760853980 | Sebandy Home Care Services, LLC | Health Maintenance Organization | 2548 Lisa Ln Ne, Rochester, MN 55906 | 2015-10-14 |
| 1538550611 | Rachel Eldersveld | Nurse Practitioner | 716 12th Ave Ne, Rochester, MN 55906 | 2015-02-11 |
| 1639590045 | Riverstone Psychological Services | Community/Behavioral Health | 511 Northern Hills Dr Ne, Suite 2, Rochester, MN 55906 | 2014-01-02 |
| 1396177457 | Marjorie Evelyn Murray | Custodial Care Facility | 4501-22nd Ave N.e., Rochester, MN 55906 | 2013-07-31 |
| 1447532411 | Peter M Holm | Dentist | 120 North Broadway Ne, Suite B, Good Samaritan Dental Clinic, Rochester, MN 55906 | 2011-09-15 |
| 1154615193 | Amy Johnson Tremain | Psychologist | 3228 6th Ave Ne Unit B, Rochester, MN 55906 | 2011-06-07 |
| 1235451816 | Connie Krueger | Dental Hygienist | 120 North Broadway, Ne, Suite B, Rochester, MN 55906 | 2010-02-23 |
| 1700115508 | Smn Home Care, LLC | Home Health | 1700 N. Broadway, Suite 114, Rochester, MN 55906 | 2009-12-08 |
| 1528395068 | Ryley D Layden | Chiropractor | 3169 Wellner Dr. Ne, Suite C, Rochester, MN 55906 | 2009-11-04 |
| Find all providers in zip 55906 | ||||
| Taxonomy Code | 103TA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376734707 | Thomas Richard Zastowny | Psychologist | 1513 South Ave, Rochester, NY 14620-2926 | 2007-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750999546 | Serenity Behavioral Health & Wellness, LLC | Psychologist | 18318 Lansford Path, Lakeville, MN 55044-4955 | 2020-07-17 |
| 1285290072 | Summit Clinics Pllc | Psychologist | 2115 County Road D E Ste C, Maplewood, MN 55109-5353 | 2019-05-16 |
| 1013357797 | Kari Michelle-ferber Maynard | Psychologist | 520 2nd Ave Se, Pine City, MN 55063-1505 | 2013-06-26 |
| 1982917415 | Jeffrey Hill | Psychologist | 1056 Centerville Cir, Vadnais Heights, MN 55127-6360 | 2010-07-26 |
| 1053631622 | Heather J Johnson | Psychologist | 4601 Excelsior Blvd Ste 411, St Louis Park, MN 55416-4977 | 2010-06-07 |
| 1144495391 | David Edward Schlack | Psychologist | 1326 East Ripley Street, Litchfield, MN 55355 | 2008-04-29 |
| 1104974674 | Susan Marie Hoisington | Psychologist | 2120 Park Ave, Minneapolis, MN 55404-3378 | 2007-01-08 |
| 1902902638 | Sharon Stein Mcnamara Ed D Psychology Inc | Psychologist | 4700 Lexington Ave N Ste B1a, Shoreview, MN 55126-5867 | 2006-09-16 |
| 1235240284 | Ann Virginia Hobbick | Psychologist | 7590 Lyric Lane Ne, Unity Hosptial, Fridley, MN 55432 | 2006-08-31 |
| 1942221080 | Innovative Psychological Consultants, LLC | Psychologist | 7372 Kirkwood Ct, Maple Grove, MN 55369-5202 | 2006-07-22 |
| Find all providers with the same taxonomy | ||||
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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.