ROSE MARY BOERBOOM (NPI# 1801208566) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801208566 |
| Entity Type | Individual |
| Full Name | ROSE MARY BOERBOOM |
| Credential | MA LP |
| Practice Address |
415 N 1st St #502 Minneapolis MN 55401-4305 |
| Practice Telephone | 6129986787 |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2014-05-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP 3481 | MN | Behavioral Health & Social Service Providers |
| Street Address |
415 N 1ST ST #502 |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55401-4305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467805721 | Vision Dreamwork | Community/Behavioral Health | 415 N 1st St, #502, Minneapolis, MN 55401-4305 | 2016-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316410012 | Janessa Angelica Beebe | Counselor | Cornerstone Therapy and Recovery Center, 1600 University Avenue West Suite #203, St. Paul, MN 55401 | 2019-01-04 |
| 1144706094 | Adrienne Sharma | Psychologist | 708 North 1st Street, Suite #242, Minneapolis, MN 55401 | 2018-07-13 |
| 1023511904 | Angela Perriman Dogins | Nurse Practitioner | 100 Washington Avenue South, Suite 900, Minneaplois, MN 55401 | 2018-03-16 |
| 1962924472 | Accuquest Hearing Centers, LLC | Clinic/Center | 2620 Steward Ave., Suite 114, Wausau, WI 55401 | 2017-07-17 |
| 1699186932 | Ross Schilling | Chiropractor | 250 2nd Avenue South, 286, Minneapolis, MN 55401 | 2014-05-08 |
| 1548516974 | Minnesota International Middle School | Local Education Agency (LEA) | 227 12th Ave N, Minneapolis, MN 55401 | 2012-08-03 |
| 1194919316 | Lynn Spaw | Nurse Practitioner | 333 Washington Avenue S, Suite 5000, Minneapolis, MN 55401 | 2007-08-30 |
| 1811947500 | Daniel Warren Eurman | Radiology | 100 3rd Ave S Unit 1507, Minneapolis, MN 55401 | 2006-05-11 |
| 1215928015 | Virginia Karen Vaughn | Nurse Practitioner | Minuteclinic 333 Washington Ave. North, Suite 5000, Minneapolis, MN 55401 | 2005-10-31 |
| 1447550876 | Walter Lee Bailey | Neurological Surgery | 500 River St, Minneapolis, MN 55401 | 2010-11-02 |
| Find all providers in zip 55401 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073826913 | Scott Michael Jacoby | Psychologist | 2110 Lyndale Ave S, Minneapolis, MN 55405-3196 | 2010-07-20 |
| 1174686216 | Susan A Medo | Psychologist | 100 W Franklin Ave, Minneapolis, MN 55404-2433 | 2006-12-19 |
| 1447338702 | Eric Larsson | Psychologist | 2925 Dean Pkwy, Suite 300, Minneapolis, MN 55416-4470 | 2006-11-02 |
| 1417035551 | Jennifer Lynn Joseph | Psychologist | 3001 Broadway St Ne, Suite 185, Minneapolis, MN 55413-2195 | 2006-11-02 |
| 1942380316 | Janice L Ostrom | Psychologist | 4535 Washburn Ave N, Minneapolis, MN 55412-1055 | 2006-10-17 |
| 1740376268 | Debra Ann Stack | Psychologist | 2124 Dupont Avenue South #104, Minneapolis, MN 55403 | 2006-10-04 |
| 1194093641 | Kavita Mahesh Desai | Psychologist | 2545 Chicago Ave S, Suite 306, Mail Stop 17-306, Minneapolis, MN 55404-4543 | 2011-12-12 |
| 1649411406 | Meredith L. Gunlicks-stoessel | Psychologist | 2450 Riverside Ave, F256/2b West, Department of Psychiatry, Minneapolis, MN 55454-1450 | 2009-03-09 |
| 1114083540 | Brih Design LLC | Psychologist | 4535 Washburn Ave N, Minneapolis, MN 55412-1055 | 2006-12-29 |
| 1003987983 | Murray Joseph Mcallister | Psychologist | 800 E 28th St, Minneapolis, MN 55407-3723 | 2006-11-13 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55401 |
Please comment or provide details below to improve the information on ROSE MARY BOERBOOM.
| 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.