MARK CHRISTOPHER GOETZ (NPI# 1780978023) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780978023 |
| Entity Type | Individual |
| Full Name | MARK CHRISTOPHER GOETZ |
| Credential | PHD |
| Practice Address |
11269 Jefferson Hwy N Champlin MN 55316-3123 |
| Mailing Address |
401 14th Ave Se Puyallup WA 98372 |
| Practice Telephone | 7632360600 |
| Mailing Telephone | (253) 697-2700 |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2017-05-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
PY60230406 | WA | Behavioral Health & Social Service Providers |
| N | 103TC1900X |
Psychologist Specialization: Counseling |
Behavioral Health & Social Service Providers | ||
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
PY60230406 | WA | Behavioral Health & Social Service Providers |
| N | 103TF0000X |
Psychologist Specialization: Family |
Behavioral Health & Social Service Providers | ||
| N | 103TR0400X |
Psychologist Specialization: Rehabilitation |
Behavioral Health & Social Service Providers | ||
| N | 208100000X | Physical Medicine & Rehabilitation | PY60230406 | WA | Allopathic & Osteopathic Physicians |
| N | 103TH0004X |
Psychologist Specialization: Health |
Behavioral Health & Social Service Providers |
| Street Address |
11269 JEFFERSON HWY N |
| City | CHAMPLIN |
| State | MN |
| Zip Code | 55316-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508849530 | Kaye Ann Marie Abel | Pediatrics | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2005-11-23 |
| 1801402722 | Allina Health System | Clinic/Center | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2020-09-16 |
| 1578175501 | Tonya Lynn Freeman | Psychologist | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2020-08-20 |
| 1386180875 | Erin Erickson | Registered Nurse | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2017-01-09 |
| 1780075630 | Katelyn Moritz | Nurse Practitioner | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2015-02-13 |
| 1952719254 | Ellen Fastner | Nurse Practitioner | 11269 Jefferson Hwy N, Champlin, MN 55316 | 2014-07-30 |
| 1215371471 | Chameng V Vang | Family Medicine | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2013-04-18 |
| 1871899674 | Allina Health System | Clinic/Center | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2011-01-27 |
| 1497989214 | Allison R Hotujec | Family Medicine | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2009-05-07 |
| 1740424928 | Lea Hilda Ekochin | Internal Medicine | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2009-05-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1598300675 | Dentalign, Pa | Dentist | 11942 Business Park Blvd, Champlin, MN 55316 | 2019-11-12 |
| 1811463573 | Vikings Home Health Care LLC | Meals | 11551 Georgia Ave, N, Champlin, MN 55316 | 2018-10-22 |
| 1255853305 | Matthew L Boelter | Hearing Instrument Specialist | 11451 Oregon Ave N, Champlin, MN 55316 | 2017-07-11 |
| 1194198309 | Champlin Dentistry, PC | Dentist | 11231 Aquila Drive N, Champlin, MN 55316 | 2015-11-10 |
| 1336557412 | Kelsey Voigt | Pharmacist | 11990 Business Park Blvd, Champlin, MN 55316 | 2014-08-01 |
| 1346502523 | Transitions Home Care Ltd | Home Health | 11030 Douglas Drive North, Champlin, MN 55316 | 2012-06-13 |
| 1639373285 | Michael D Smilanich | Dentist | 11231 Aquila Dr N, Champlin, MN 55316 | 2007-06-14 |
| 1760532907 | Kurt Allan Bender | Dentist | 500 A Jefferson Hwy, Champlin, MN 55316 | 2007-01-11 |
| 1366529752 | Gregory Allan Holmberg | Chiropractor | #8 3rd Street Nw, Osseo, MN 55316 | 2006-11-01 |
| Find all providers in zip 55316 | ||||
| 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 |
|---|---|---|---|---|
| 1982103644 | Veemah Integrated Wellness & Consulting Services, LLC | Psychologist | 11112 Hillsboro Ave N, Champlin, MN 55316-3128 | 2018-02-08 |
| 1578175501 | Tonya Lynn Freeman | Psychologist | 11269 Jefferson Hwy N, Champlin, MN 55316-3123 | 2020-08-20 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.