ASSOCIATED CLINIC OF PSYCHOLOGY INC (NPI# 1588741292) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588741292 |
| Entity Type | Organization |
| Organization Name | ASSOCIATED CLINIC OF PSYCHOLOGY INC |
| Practice Address |
4027 County Road 25 St Louis Park MN 55416 |
| Mailing Address |
4240 Park Glen Rd St Louis Park MN 55416-4758 |
| Practice Telephone | 6129256033 |
| Practice Fax Number | 6129258496 |
| Mailing Telephone | 6129256033 |
| Mailing Fax Number | 6129258496 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-09-06 |
| Authorized Official Name | DR. JOHN E BROSE (CEO) |
| Authorized Official Telephone | 6129256033 |
| Authorized Official Credential | PHD LP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
811029-1-MHC | MN | Ambulatory Health Care Facilities |
| N | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
811029-1-MHC | MN | Ambulatory Health Care Facilities |
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
811029-1-MHC | MN | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 277723100 | 05 | |
| MN | BCBS | 475-94AS | 01 |
| MN | HEALTHPARTNERS | 3920 | 01 |
| MN | RAILROAD MEDICARE | CT0661 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6950 146th St W Ste 100, Apple Valley, MN 551246544 | 9524321484 | 9524322328 |
| 149 Thompson Ave E Ste 150, West St Paul, MN 551183238 | 6514500860 | 6514500759 |
| 1155 Ford Rd Ste B, St Louis Park, MN 554261115 | 9523781800 | 9523781714 |
| 6200 Shingle Creek Pkwy Ste 350, Brooklyn Center, MN 554302155 | 7635038560 | 7635038563 |
| 450 Syndicate St N Ste 385, Saint Paul, MN 551044219 | 6129256033 | 6129258496 |
| 4240 Park Glen Rd, St Louis Park, MN 554164758 | 6129256033 | 6129258496 |
| 4027 County Road 25, St Louis Park, MN 55416 | 6129256033 | 6129258496 |
| Street Address |
4027 COUNTY ROAD 25 |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477531960 | Paul Andrew Ekberg | Psychiatry & Neurology | 4027 County Road 25, St Louis Park, MN 55416 | 2006-01-04 |
| 1013534817 | Sarah Joy Najafalipour | Counselor | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-06-29 |
| 1881213395 | J Niva Capecchi-nguyen | Social Worker | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-04-14 |
| 1770112963 | Rebekah Sue Aronson | Social Worker | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-04-08 |
| 1922632728 | Marilyn Violet Court | Marriage & Family Therapist | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-03-02 |
| 1811537632 | Tatum Karos | Nurse Practitioner | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2020-01-09 |
| 1962041590 | Natasha Kaslow Satre | Social Worker | 4027 County Road 25, St Louis Park, MN 55416-2629 | 2019-12-30 |
| 1689216855 | Margaret Susan Eide Bremer | Counselor | 4027 County Road 25, St Louis Park, MN 55416 | 2019-10-09 |
| 1932759941 | Linnea Gene Borer | Social Worker | 4027 County Road 25, St Louis Park, MN 55416 | 2019-09-12 |
| 1144782434 | Teresa Bhavana Schuchman Falk | Social Worker | 4027 County Road 25, St Louis Park, MN 55416 | 2019-04-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992265615 | Sbtv LLC | Clinic/Center | 6121 Excelsior Blvd Ste 101a, St Louis Park, MN 55416-2752 | 2019-03-20 |
| 1053979435 | Mcgovern Psychotherapy, LLC | Clinic/Center | 3340 Republic Ave Ste 120, St Louis Park, MN 55426-4189 | 2019-05-31 |
| 1881184778 | Colleen Morrissette, Pllc | Clinic/Center | 3340 Republic Ave, St Louis Park, MN 55426-4154 | 2018-05-16 |
| 1699265470 | Megan Gingo Counseling, Pllc | Clinic/Center | 3340 Republic Ave, St Louis Park, MN 55426-4154 | 2018-05-16 |
| 1225326036 | Caspersen, LLC | Clinic/Center | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416-2929 | 2011-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821698671 | St. Cloud Tms LLC | Clinic/Center | 925 E Superior St Ste 106, Duluth, MN 55802-2253 | 2020-10-30 |
| 1740880764 | East Metro Trauma and Recovery LLC | Clinic/Center | 4116 Hoffman Rd, White Bear Lake, MN 55110-3708 | 2020-10-28 |
| 1851991160 | Gratia Counseling & Consulting, LLC | Clinic/Center | 2705 Bunker Lake Blvd Nw Ste 103, Andover, MN 55304-3786 | 2020-10-27 |
| 1508465147 | Piece of Mind Counseling Services, Pllc | Clinic/Center | 1122 Bemidji Ave N, Bemidji, MN 56601-2833 | 2020-10-24 |
| 1205433984 | Hopebridge Life Skills Center | Clinic/Center | 3617 E Lake St, Minneapolis, MN 55406-2148 | 2020-10-05 |
| 1275149007 | Clarity Counseling Services Pllc | Clinic/Center | 521 W Highway 2, Cohasset, MN 55721-2300 | 2020-09-17 |
| 1720693146 | Serene Therapy and Counseling Services LLC | Clinic/Center | 777 Berry St Apt 400b, Saint Paul, MN 55114-4006 | 2020-09-11 |
| 1427662592 | Threesixty, LLC | Clinic/Center | 4960 Miller Trunk Hwy # 600-b, Hermantown, MN 55811-1891 | 2020-09-04 |
| 1124639190 | Woodhaven Wellness | Clinic/Center | 3000 Carriage Dr, Hamel, MN 55340-9597 | 2020-08-13 |
| 1245840735 | Kalina Counseling Services | Clinic/Center | 120 7th St Unit 101, Two Harbors, MN 55616-1563 | 2020-08-09 |
| Find all providers with the same taxonomy | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
Please comment or provide details below to improve the information on ASSOCIATED CLINIC OF PSYCHOLOGY INC.
| 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.