DR. ETHAN MCCALLUM


Address: 715 2nd Ave S, Hopkins, MN 55343-7782
Phone: 9524281900

DR. ETHAN MCCALLUM (NPI# 1851703110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851703110
Entity Type Individual
Full Name DR. ETHAN MCCALLUM
Credential PHD
Practice Address 715 2nd Ave S
Hopkins
MN 55343-7782
Mailing Address 1 Veterans Dr
116a
Minneapolis
MN 55417-2309
Practice Telephone 9524281900
Mailing Telephone 6124671878
Enumeration Date 2014-05-21
Last Update Date 2018-01-09
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103T00000X Psychologist Behavioral Health & Social Service Providers

Office Location

Street Address 715 2ND AVE S
City HOPKINS
State MN
Zip Code 55343-7782

Providers in the same location

NPI Name Taxonomy Address Enumeration
1609821339 Karen Ann Frees Social Worker 715 2nd Ave S, Hopkins, MN 55343-7782 2006-05-23
1386196418 Carlyn Penwell Advanced Practice Midwife 715 2nd Ave S, Hopkins, MN 55343-7782 2016-10-24
1891249504 Ann Elizabeth Rice Advanced Practice Midwife 715 2nd Ave S, Hopkins, MN 55343-7782 2016-08-10
1447556220 Allina Health System Clinic/Center 715 2nd Ave S, Hopkins, MN 55343-7782 2011-01-27
1821237298 Kristin L Paul-gatyas Advanced Practice Midwife 715 2nd Ave S, Hopkins, MN 55343-7782 2009-02-09
1699945550 Carolyn Beth Andrae Physician Assistant 715 2nd Ave S, Hopkins, MN 55343 2008-03-06
1447280268 Neil Hoffman Internal Medicine 715 2nd Ave S, Hopkins, MN 55343-7782 2006-07-04
1508895822 Timothy L Miller Internal Medicine 715 2nd Ave S, Hopkins, MN 55343-7782 2006-06-30

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689230542 Madison C Korus Behavior Technician 5501 Feltl Road, Minnetonka, MN 55343 2019-05-16
1942708508 Teammd Physicians of Texas Inc Case Manager/Care Coordinator 9900 Bren Rd E # 8-b217, Minnetonka, MN 55343 2018-01-30
1659899284 Midwest Medical Transit Transportation Broker 1001 Main Street #125, Hopkins, MN 55343 2017-09-04
1376070367 Noor Translation and Interpretation Services LLC Interpreter 5620 Smetana Drive, Ste 300, Office D, Minnetonka, MN 55343 2017-05-22
1871043240 Katherine Rae Skarphol Speech-Language Pathologist 5501 Feltl Rd, Hopkins, MN 55343 2016-10-10
1215481478 Safi Care Transportation Non-emergency Medical Transport (VAN) 1001 Mainstreet, Ste 125, Hopkins, MN 55343 2016-08-05
1649723420 Stephanie Stackhouse Internal Medicine 5520 Bristol Lane, Minnetonka, MN 55343 2016-07-28
1023479706 Counter Point Recovery Substance Abuse Rehabilitation Facility 5022 Baker Rd, Minnetonka, MN 55343 2016-03-09
1851766356 Enrique Mendoza Rojas Nurse Practitioner 9900 Ben Road East, Mail Route Mn 008-b213, Minnetonka, MN 55343 2015-12-09
1013307230 Susanna Monroe Nurse Practitioner Unitedhealth Group Corporate Address, 9900 Bren Road East, Minnetonka, MN 55343 2015-01-26
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Taxonomy Information

Taxonomy Code 103T00000X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1649281635 Lisa Rivers Psychologist 1001 Highway 7, Room 217, Hopkins, MN 55305-4723 2006-08-11
1346274032 Paulette G. Muni Psychologist 9711 Garners Ferry Rd, Hopkins, SC 29061-9148 2006-07-10
1619147576 Richard Steven Amado Psychologist 415 Blake Rd N, Suite 240, Hopkins, MN 55343-8108 2008-03-06
1306039854 Michael Earl Maus Psychologist 415 Blake Rd N, Suite 240, Hopkins, MN 55343-8108 2007-08-18
1801964382 Neal Allen Gillett Psychologist 10520 Wayzata Blvd, Hopkins, MN 55305-1511 2006-12-01

Providers in the same taxonomy and state

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
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Competitor

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City HOPKINS
Zip Code 55343

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Dataset Information

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.

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