DR. MARY RUTH BOEHLKE (NPI# 1609855956) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609855956 |
| Entity Type | Individual |
| Full Name | DR. MARY RUTH BOEHLKE |
| Credential | PSY.D. |
| Practice Address |
1660 Highway 100 S Ste. 568 Minneapolis MN 55416-1529 |
| Mailing Address |
17935 2nd Ave N Plymouth MN 55447-3486 |
| Practice Telephone | 9525456800 |
| Mailing Telephone | 7634764924 |
| Enumeration Date | 2006-01-14 |
| Last Update Date | 2007-07-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | MN LP0708 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BLUE CROSS OF MN | 1G186BO | 01 |
| Street Address |
1660 HIGHWAY 100 S STE. 568 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55416-1529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083842702 | Pamela J Staples | Psychologist | 1660 Highway 100 S, Suite 574, Minneapolis, MN 55416-1529 | 2009-07-01 |
| 1215197462 | Megan Leigh Beuckens | Dentist | 1660 Highway 100 S, Suite 122, Minneapolis, MN 55416-1529 | 2008-06-11 |
| 1073781431 | Molly Lynn Beckstrom | Counselor | 1660 Highway 100 S, Suite 430, Minneapolis, MN 55416-1529 | 2008-02-19 |
| 1154599611 | Lisa Marie Anderson | Counselor | 1660 Highway 100 S, Parkdale Palza #430, Minneapolis, MN 55416-1529 | 2008-02-18 |
| 1467630186 | John Bradley Mcnaught | Counselor | 1660 Highway 100 S, Suite 430, Minneapolis, MN 55416-1529 | 2008-02-05 |
| 1861670804 | Jamie Lucille Nelson | Social Worker | 1660 Highway 100 S, Suite 430, Minneapolis, MN 55416-1529 | 2008-02-01 |
| 1558549576 | Bharati Acharya | Counselor | 1660 Highway 100 S, Minneapolis, MN 55416-1529 | 2008-01-31 |
| 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 | 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 |
|---|---|---|---|---|
| 1407496516 | Liza N Meredith | Psychologist | Acacia Counseling and Wellness, 2724 University Ave Se Unit B, Minneapolis, MN 55414 | 2020-01-07 |
| 1194368191 | Luz Angelica Fehn Salinas | Psychologist | 1315 E24th St, Minneapolis, MN 55404 | 2019-10-22 |
| 1164071148 | Amy C Moran | Psychologist | Acacia Counseling & Wellness, 2724 University Ave., Unit B, Minneapolis, MN 55414 | 2019-09-11 |
| 1104482074 | Sanvello Behavioral Health Services, P.a. | Psychologist | 150 S 5th St Ste 825, Minneapolis, MN 55402-4200 | 2019-05-15 |
| 1033674726 | Kristina Marie Duncombe Lowe | Psychologist | 910 E 26th St Ste 410, Minneapolis, MN 55404-4512 | 2019-02-06 |
| 1083192223 | Krista Yucuis | Psychologist | 725 8th Ave Se, Minneapolis, MN 55414-1364 | 2018-07-31 |
| 1720564941 | Shani Ofrat | Psychologist | 1 Veterans Dr # 2g-128, Minneapolis, MN 55417-2309 | 2018-07-11 |
| 1962998997 | Steven Wolinski | Psychologist | 3830 Washburn Ave N, Minneapolis, MN 55412 | 2018-07-02 |
| 1497268122 | Andrea Lynn Potthoff | Psychologist | 7300 Metro Blvd Ste 640, Minneapolis, MN 55439-2313 | 2017-11-16 |
| 1871046912 | Christine E Bray | Psychologist | 1100 Washington Ave S, Suite 102, Minneapolis, MN 55415-1273 | 2016-07-25 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55416 |
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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.