TIM RICHARD PORTINGA (NPI# 1609924216) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609924216 |
| Entity Type | Individual |
| Full Name | TIM RICHARD PORTINGA |
| Credential | PSYD LP |
| Practice Address |
11505 36th Ave N Plymouth MN 55441-2304 |
| Practice Telephone | 7635093818 |
| Practice Fax Number | 7635590149 |
| Mailing Telephone | 7635093818 |
| Mailing Fax Number | 7635590149 |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP4699 | MN | Behavioral Health & Social Service Providers |
| Street Address |
11505 36TH AVE N |
| City | PLYMOUTH |
| State | MN |
| Zip Code | 55441-2304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619500600 | Dave R Bjorklund | Counselor | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2020-02-18 |
| 1588295208 | Venessa Ferrier | Counselor | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2020-01-31 |
| 1710488655 | Sarah Schwalbach | Marriage & Family Therapist | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2018-02-26 |
| 1376902999 | Recovery Partners, PC At Plymouth | Psychologist | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2016-02-11 |
| 1194195248 | Heidi Bausch | Student in an Organized Health Care Education/Training Program | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2015-10-01 |
| 1720457526 | Nicole Steil | Student in an Organized Health Care Education/Training Program | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2015-09-22 |
| 1700283025 | Julia Edelman | Counselor | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2014-12-02 |
| 1881010114 | Nora Durkin | Counselor | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2014-03-11 |
| 1548696602 | David Matthew Wells | Psychologist | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2013-09-20 |
| 1285069880 | Kara Goldmann | Student in an Organized Health Care Education/Training Program | 11505 36th Ave N, Plymouth, MN 55441-2304 | 2013-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689190019 | The Recovery Clinic LLC | Clinic/Center | 9800 Shelard Pkwy Ste 215, Plymouth, MN 55441 | 2017-08-17 |
| 1356887186 | Katherine Marlow Bell | Dentist | 2805 Campus Dr Ste 245, Plymouth, MN 55441 | 2017-01-18 |
| 1083069538 | Mercade Waldon | Home Health Aide | 3501 Xenium Lane, Plymouth, MN 55441 | 2016-05-03 |
| 1346645538 | Phs Westhealth, Inc | Skilled Nursing Facility | 2775 Campus Drive North, Plymouth, MN 55441 | 2014-10-30 |
| 1427453125 | Samuel David Fine | Pharmacist | 4070 Goldenrod Ln, Plymouth, MN 55441 | 2014-10-24 |
| 1548672538 | Scott Aaron Schmidt | Dentist | 2720 Annapolis Circle N, Suite A, Plymouth, MN 55441 | 2014-05-23 |
| 1831498633 | Comforide Transportation Services LLC | Non-emergency Medical Transport (VAN) | 9730 37th Pl N Suite 201, Plymouth, MN 55441 | 2011-03-18 |
| 1255669271 | Tammy Kae Mehlhaus | Physician Assistant | 2855 Campus Drive, Suite 570, Plymouth, MN 55441 | 2009-12-02 |
| 1164758199 | Stephen P. Boger, Dds, Pa | Dentist | 2720 Annapolis Circle, Suite A, Plymouth, MN 55441 | 2009-10-27 |
| 1093908360 | Endodontic Professionals Pa Plymouth Endodontics | Dentist | 3401 Hwy 169 N, Plymouth, MN 55441 | 2007-08-21 |
| Find all providers in zip 55441 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790264760 | Tasha Leno | Psychologist | 595 Forest Ave Ste 7a, Plymouth, MI 48170-1777 | 2018-08-10 |
| 1679059968 | Life Improved, LLC | Psychologist | 300 Main Street, Suite 200, Plymouth, NH 03264 | 2018-07-19 |
| 1952891038 | Charles Francis Carroll | Psychologist | 17 Alvin Rd, Plymouth, MA 02360-3920 | 2018-05-15 |
| 1861914863 | Steven Schwartz | Psychologist | 12431 Howland Park Dr, Plymouth, MI 48170-2894 | 2017-07-11 |
| 1366827016 | Juliann Knochel | Psychologist | 42325 Ann Arbor Rd E, Plymouth, MI 48170-4356 | 2015-07-23 |
| 1851781959 | Stephen Mangin | Psychologist | 42245 Ann Arbor Rd E Ste 101, Plymouth, MI 48170-4311 | 2015-01-27 |
| 1649683517 | Heather M Delcourt | Psychologist | 595 Forest Ave Ste 11a, Plymouth, MI 48170-1777 | 2014-06-08 |
| 1952730723 | Amanda Michelle Henderson Bills | Psychologist | 199 N Main St Ste 200, Plymouth, MI 48170-1286 | 2013-11-02 |
| 1255779492 | Heather D Haggerty | Psychologist | 340 N Main St Ste 201, Plymouth, MI 48170-1290 | 2013-06-10 |
| 1164705471 | Ruth C. Rowbotham | Psychologist | 225 Water St Ste A115, Plymouth, MA 02360-4060 | 2011-09-22 |
| Find all providers in PLYMOUTH | ||||
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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.