GREAT RIVER PSYCHOTHERAPY PLLC (NPI# 1588206940) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588206940 |
| Entity Type | Organization |
| Organization Name | GREAT RIVER PSYCHOTHERAPY PLLC |
| Practice Address |
790 Cleveland Ave S Ste 201 Saint Paul MN 55116-3845 |
| Practice Telephone | 6515037391 |
| Mailing Telephone | 6515037391 |
| Enumeration Date | 2019-10-16 |
| Last Update Date | 2020-04-08 |
| Authorized Official Name | DR. LISA PAIGE ROGERS (CO-OWNER) |
| Authorized Official Telephone | 6515037391 |
| Authorized Official Credential | PHD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 680003000 | 05 |
| Street Address |
790 CLEVELAND AVE S STE 201 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55116-3845 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285706507 | Lisa Rogers | Psychologist | 790 Cleveland Ave S Ste 201, Saint Paul, MN 55116-3845 | 2006-11-14 |
| 1134728819 | Dale Raymond Hawley | Marriage & Family Therapist | 790 Cleveland Ave S Ste 201, Saint Paul, MN 55116-3845 | 2020-10-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568017374 | The Bridge Autism Clinic LLC | Clinic/Center | 690 Cleveland Ave South, Suite 100, St Paul, MN 55116 | 2019-08-08 |
| 1205306875 | Center for Validation and Change, L.L.C. | Social Worker | 790 Cleveland Avenue S. Ste; 211 790, St. Paul, MN 55116 | 2018-11-27 |
| 1114391307 | Therese Ann Wengler | Rehabilitation Hospital | 1206 Niles Avenue, Saint Paul, MN 55116 | 2015-11-25 |
| 1306220579 | Lauren Ann Wier | Social Worker | 577 Wawick St, Saint Paul, MN 55116 | 2015-07-16 |
| 1982097325 | Norah Hoverson | Dentist | 670 Cleveland Ave S Ste 100, Saint Paul, MN 55116 | 2015-03-10 |
| 1316336803 | Ryan W. Nolte | Chiropractor | 1150 Montreal Ave Ste 101, Saint Paul, MN 55116 | 2015-01-21 |
| 1316348642 | Highland Gw, LLC | Assisted Living Facility | 1925 Graham Avenue, St. Paul, MN 55116 | 2014-09-05 |
| 1972941185 | Creations Midwifery, LLC | Advanced Practice Midwife | 1235 Saint Paul Avenue, Saint Paul, MN 55116 | 2013-06-10 |
| 1992075428 | Nels Health Care, LLC | Licensed Practical Nurse | 2285 Stewart Ave, Suite 1107, St Paul, MN 55116 | 2011-12-30 |
| 1962717728 | Lindsey Hammond Teigland | Psychologist | 690 Cleveland Avenue South, St. Paul, MN 55116 | 2010-08-17 |
| Find all providers in zip 55116 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669992186 | Stephanie Bruss | Psychologist | 821 Raymond Ave # 130c, Saint Paul, MN 55114-1503 | 2017-06-26 |
| 1679977326 | Jennifer D. Karel | Psychologist | 1123 Grand Ave Ste 301, Saint Paul, MN 55105-2629 | 2014-10-09 |
| 1699038265 | Minnesota Organization On Fetal Alcohol Syndrome (mofas) | Psychologist | 2233 University Ave W Ste 395, Saint Paul, MN 55114-1600 | 2012-06-19 |
| 1821356098 | Mainhia Khang | Psychologist | 393 Dunlap St N Ste 105, Saint Paul, MN 55104-4211 | 2012-04-25 |
| 1609153378 | Quo Psychotherapy, P.a. | Psychologist | 821 Raymond Ave Ste 230c, Saint Paul, MN 55114-1525 | 2011-11-09 |
| 1831486216 | Bonnie Sue Mcmillin | Psychologist | 457 Portland Ave, 3, Saint Paul, MN 55102-2499 | 2011-07-06 |
| 1285935064 | Sarah L. Hart, Ph.d., LLC | Psychologist | 241 Cleveland Ave S Ste P, Saint Paul, MN 55105-1208 | 2010-11-09 |
| 1003149717 | Tamarind Knutson | Psychologist | 1360 Energy Park Dr Ste 340, Saint Paul, MN 55108-5298 | 2009-09-13 |
| 1659604874 | Andrea Elizabeth Anderson | Psychologist | 2383 University Ave W Ste 200, U.S. Bank Building, Second Floor, Saint Paul, MN 55114-1603 | 2009-09-08 |
| 1639307622 | Nicole Heffron, LLC | Psychologist | 889 Grand Ave, Suite 202, Saint Paul, MN 55105-3008 | 2009-06-29 |
| Find all providers in SAINT PAUL | ||||
| City | SAINT PAUL |
| Zip Code | 55116 |
Please comment or provide details below to improve the information on GREAT RIVER PSYCHOTHERAPY PLLC.
| 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.