GEOFFREY CLYDE AMMERMAN (NPI# 1356373328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356373328 |
| Entity Type | Individual |
| Full Name | GEOFFREY CLYDE AMMERMAN |
| Credential | MS.ED., LP |
| Practice Address |
927 Trettel Ln Cloquet MN 55720-1345 |
| Practice Telephone | 2188791227 |
| Mailing Telephone | 2188791227 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2017-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP1904 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 870748100 | 05 |
| Street Address |
927 TRETTEL LN |
| City | CLOQUET |
| State | MN |
| Zip Code | 55720-1345 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427044239 | Janette Mary Setterquist | Registered Nurse | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2005-09-27 |
| 1568070498 | York Marlowe | Counselor | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2020-07-16 |
| 1972149623 | Abigail Nancy Anderson | Physician Assistant | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2019-11-18 |
| 1245897438 | Sophia Stangl | Dentist | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2019-05-22 |
| 1386201572 | Shelia Marie Miller | Social Worker | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2019-05-22 |
| 1598246142 | Leann Mae Butler | Nurse Practitioner | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2018-08-22 |
| 1093200826 | Robert Alexander Johnson | Dentist | 927 Trettel Ln, Cloquet, MN 55720 | 2018-06-25 |
| 1780173534 | Ariane Marene Norrgard | Social Worker | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2018-05-08 |
| 1811405368 | Barbara Ann Heikkila | Dietitian, Registered | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2018-01-18 |
| 1659886026 | Katherine Gokee | Health Educator | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2017-12-07 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447786652 | Awakening Growth, LLC | Social Worker | 116 Ave C, Cloquet, MN 55720 | 2017-05-08 |
| 1396129706 | Kara Danielle Ebert | Marriage & Family Therapist | 913 Stanley Ave, Cloquet, MN 55720 | 2015-07-15 |
| 1639577729 | Fcsl Cloquet, LLC | Assisted Living Facility | 130 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1699173765 | Fcsl Cloquet, LLC | Assisted Living Facility | 132 W North Road, Cloquet, MN 55720 | 2014-12-05 |
| 1134426778 | Fond Du Lac Reservation Business Committee | Assisted Living Facility | 1571 Airport Road, Fond Du Lac Assisted Living, Cloquet, MN 55720 | 2011-02-17 |
| 1417124553 | Kara Lynn Fausch | Family Medicine | 512 Skyline Boulevard, Cloquet, MN 55720 | 2008-05-08 |
| 1013199769 | Carlton Co Public Health & Human Services | Public Health or Welfare | 30 N 10th Street, Cloquet, MN 55720 | 2007-12-04 |
| 1881808616 | Stephen David Parkhurst | Chiropractor | 903 Cloquet Avenue, Cloquet, MN 55720 | 2007-05-10 |
| 1093929861 | Northland Afc,inc | Day Training, Developmentally Disabled Services | 1576 White Pine Trail, Cloquet, MN 55720 | 2007-05-10 |
| 1235341231 | Northland Afc,inc | Day Training, Developmentally Disabled Services | 6580 W Arrowhead Rd., Cloquet, MN 55720 | 2007-05-04 |
| Find all providers in zip 55720 | ||||
| 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 |
|---|---|---|---|---|
| 1588675581 | David G. Lee | Psychologist | 30 10th St N, Cloquet, MN 55720-1634 | 2006-08-11 |
| 1912316779 | Angelique Gillis | Psychologist | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2014-08-06 |
| 1821333170 | John Richard Latson | Psychologist | 707 Highway 33 S, Suite 9b, Cloquet, MN 55720-2696 | 2012-11-27 |
| 1780730523 | Gregory B Goodrich | Psychologist | 927 Trettle Lane, Fond Du Lac Human Services Division, Cloquet, MN 55720 | 2007-01-26 |
| 1427135342 | Jane M. L. Howard | Psychologist | 927 Trettel Ln, Cloquet, MN 55720-1345 | 2006-11-01 |
| 1518067784 | Jean L Pierce | Psychologist | 40 11th St, Cloquet, MN 55720-1817 | 2006-09-25 |
| 1073542981 | Jane M Anderson | Psychologist | 40 11th St, Cloquet, MN 55720-1817 | 2006-07-02 |
| 1639108574 | Daniel Patrick D'allaird | Psychologist | 40 11th St, Cloquet, MN 55720-1817 | 2006-07-02 |
| 1962431205 | James Leonard Youngman | Psychologist | 40 11th St, Cloquet, MN 55720-1817 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493952 | Michelle Brownfield | Psychologist | 606 Spear Ave, Duluth, MN 55803-2154 | 2020-10-01 |
| 1730716994 | Tamolyn Patterson Benke | Psychologist | 8453 Casey Ct, Inver Grove Heights, MN 55076-5154 | 2020-03-26 |
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1134764871 | Avital Ogniewicz | Psychologist | 2519 Commerce Dr Nw, Rochester, MN 55901-4432 | 2019-11-15 |
| 1164065868 | Karen Nicole Chinnock | Psychologist | 930 Blue Gentian Rd, Eagan, MN 55121-1674 | 2019-10-25 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1083257349 | Nathaniel Page | Psychologist | 2423 Valley Dr, Northfield, MN 55057-3224 | 2019-10-18 |
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1881243590 | Bill Clafton Psyd Lp LLC | Psychologist | 1755 Old West Main St Ste 204, Red Wing, MN 55066-3057 | 2019-09-05 |
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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.