ACTIFY NEUROTHERAPIES, PLLC (NPI# 1174156152) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1174156152 |
Entity Type | Organization |
Organization Name | ACTIFY NEUROTHERAPIES, PLLC |
Practice Address |
115 Elm St Ste I Farmington MN 55024-1031 |
Mailing Address |
800 Bunn Dr Ste 304 Princeton NJ 08540-1968 |
Practice Telephone | 8885668774 |
Mailing Telephone | 8885668774 |
Enumeration Date | 2020-02-18 |
Last Update Date | 2020-02-18 |
Authorized Official Name | STEVEN LEVINE (MANAGING MEMBER) |
Authorized Official Telephone | 6096514429 |
Authorized Official Credential | MD |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1184257032 | Actify Neurotherapies, Pllc | Psychiatry & Neurology | 10720 W Indian School Rd Ste 19, Phoenix, AZ 85037-5799 | 2020-02-19 |
1083247134 | Actify Neurotherapies, Pllc | Psychiatry & Neurology | 28475 Greenfield Rd Ste 113, Southfield, MI 48076-3034 | 2020-02-18 |
Street Address |
115 ELM ST STE I |
City | FARMINGTON |
State | MN |
Zip Code | 55024-1031 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932758158 | Renetia Jackson | Technician | 1210 Spruce Street, Farmington, MN 55024 | 2019-09-10 |
1871094912 | Megan Provost | Registered Nurse | 17680 Formosa Ave, Farmington, MN 55024 | 2018-02-23 |
1356752463 | Your Vision Achieved, LLC | Marriage & Family Therapist | 5404 187th Street West, Farmington, MN 55024 | 2014-05-12 |
1427304203 | Joseph Samuel Emond Jr. | Family Medicine | 19730 Meadowlark Way, Farmington, MN 55024 | 2012-07-30 |
1053680991 | Annie Lee Mickelson | Chiropractor | 20700 Chippendale Ave Suite 7, Farmington, MN 55024 | 2011-12-21 |
1770770828 | Grand St Paul Cvs LLC | Durable Medical Equipment & Medical Supplies | 19605 Pilot Knob Rd., Farmington, MN 55024 | 2007-10-02 |
1275725277 | Family Vision Clinic of Farmington | Optometrist | 19650 Pilot Knob Road, Farmington, MN 55024 | 2007-08-14 |
1871503136 | Independent School District #192 | Early Intervention Provider Agency | 20655 Flagstaff Avenue, Farmington, MN 55024 | 2006-08-09 |
1588692669 | Northfield Hospital | Clinic/Center | 4645 Knutsen Dr, Farmington, MN 55024 | 2006-06-29 |
1902887284 | David E Truax | Chiropractor | 20700 Chippendale Ave, Suite 7, Farmington, MN 55024 | 2005-11-14 |
Find all providers in zip 55024 |
Taxonomy Code | 2084P0800X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Psychiatry |
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679950984 | Jafreen Ahmed | Psychiatry & Neurology | 263 Farmington Ave # Mc1410, Farmington, CT 06030-0002 | 2015-05-06 |
1568705978 | Phelan Elizabeth Maruca-sullivan | Psychiatry & Neurology | 10 Talcott Nothc, Farmington, CT 06032-0001 | 2013-04-03 |
1659647519 | Thomas J. Vanhoof | Psychiatry & Neurology | 14 Crestwood Cir, Farmington, CT 06032-1123 | 2012-03-26 |
1134312671 | David Matuskey | Psychiatry & Neurology | 10 Talcott Notch Rd Ste 3e, Farmington, CT 06032-1800 | 2007-08-18 |
1275639106 | John Sytsma | Psychiatry & Neurology | 144 High St, Farmington, ME 04938-1946 | 2006-09-16 |
1629084710 | Matthew J Gardiner | Psychiatry & Neurology | 808 Spring Pond Dr, Farmington, UT 84025-3853 | 2006-07-31 |
1457371049 | Sohrab Zahedi | Psychiatry & Neurology | 6 Forest Park Dr, Suite # 5, Farmington, CT 06032-1480 | 2006-07-19 |
1366474462 | Carole Black Cohen | Psychiatry & Neurology | 10 Forest Park Dr, Farmington, CT 06032-1499 | 2006-07-07 |
1386613354 | Glenn Konopaske | Psychiatry & Neurology | Uconn Health, Dept. of Psychiatry, 263 Farmington Ave, Farmington, CT 06030-0001 | 2006-03-14 |
1285609131 | Michael Susco | Psychiatry & Neurology | 1386 Hathaway Dr, Suite A, Farmington, NY 14425-8973 | 2006-02-22 |
Find all providers in FARMINGTON |
City | FARMINGTON |
Zip Code | 55024 |
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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.