MARK R FASTNER (NPI# 1942278577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942278577 |
| Entity Type | Individual |
| Full Name | MARK R FASTNER |
| Credential | MA LP |
| Practice Address |
1811 Weir Drive Suite 355 Mail Stop 13701a Woodbury MN 55125-2273 |
| Mailing Address |
8100 34th Ave S 21110q Bloomington MN 55425-1672 |
| Practice Telephone | 6517306151 |
| Practice Fax Number | 6517301700 |
| Mailing Telephone | 9528837961 |
| Mailing Fax Number | 9528835395 |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2844 | MN | Behavioral Health & Social Service Providers |
| Street Address |
1811 WEIR DRIVE SUITE 355 MAIL STOP 13701A |
| City | WOODBURY |
| State | MN |
| Zip Code | 55125-2273 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164495016 | Darrel L Cotch | Physician Assistant | 1811 Weir Drive, Suite 355, Woodbury, MN 55125-2273 | 2006-02-10 |
| 1437698453 | Lisa Kingsbury | Counselor | 1811 Weir Drive, Suite 270, Woodbury, MN 55125 | 2017-02-23 |
| 1831560986 | Jennifer Danielson | Psychologist | 1811 Weir Drive, Suite 355, Woodbury, MN 55125 | 2015-10-15 |
| 1598194201 | Kristy Lee Burgess | Marriage & Family Therapist | 1811 Weir Drive, Suite 270, Woodbury, MN 55125 | 2013-11-03 |
| 1174759773 | Teresa L Winston | Counselor | 1811 Weir Drive, Suite 270, Woodbury, MN 55125 | 2009-06-09 |
| 1942275235 | Jeanette L Zaczkowski | Social Worker | 1811 Weir Drive, Suite 355 Mail Stop 13701a, Woodbury, MN 55125-2273 | 2006-02-21 |
| 1316910268 | Peter B Brandenhoff | Social Worker | 1811 Weir Drive, Suite 355 Mail Stop 13701a, Woodbury, MN 55125-2273 | 2006-02-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487268728 | Haley Kirkpatrick | Behavior Technician | 721 Commerce Dr., Woodbury, MN 55125 | 2020-09-03 |
| 1689218091 | Jordan Schmidt | Student in an Organized Health Care Education/Training Program | 1740 Welr Dr. #24, Woodbury, MN 55125 | 2019-10-30 |
| 1629619580 | Mackenzie Ann Funke | Occupational Therapist | 721 Commerce Drivve, Woodbury, MN 55125 | 2019-10-02 |
| 1700342029 | Darcy Stivland | Counselor | 1811 Weir Drive #270, Woodbury, MN 55125 | 2019-02-11 |
| 1235609884 | Elizabeth Kennedy Ward | Psychologist | 7582 Currell Blvd Suite 208, Woodbury, MN 55125 | 2018-11-27 |
| 1528573664 | Cory Lee Baumeister | Counselor | 652 Bielenberg Dr, Woodbury, MN 55125 | 2017-12-12 |
| 1760918239 | David James Knight | Dentist | 9950 Valley Creek Rd Ste 150, Woodbury, MN 55125 | 2017-05-03 |
| 1366988826 | Mark Your Home Health Care LLC | Home Health | 6053 Hudson Road, Suite 200, Woodbury, MN 55125 | 2017-01-09 |
| 1518415736 | Kubei Holdings Group LLC | Case Management | 6043 Hudson Rd Ste 340, Saint Paul, MN 55125 | 2016-09-16 |
| 1285087072 | Adrian Jung | Occupational Therapist | 155 Radio Drive, Woodbury, MN 55125 | 2016-07-18 |
| Find all providers in zip 55125 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932573599 | Jd Psychological Services, PC | Psychologist | 10 Lower Cmns, Woodbury, CT 06798-3219 | 2015-11-19 |
| 1124425756 | Reflective Psychology Associates, Pllc | Psychologist | 144 Woodbury Rd, 16, Woodbury, NY 11797-1418 | 2014-11-25 |
| 1750722195 | Craig Martin Roelke | Psychologist | 6063 Hudson Rd, Suite 200, Woodbury, MN 55125-4454 | 2013-07-15 |
| 1023389186 | Amy Hilburger | Psychologist | 576 Bielenberg Dr Ste 250, Woodbury, MN 55125-1739 | 2012-01-21 |
| 1134457047 | Behavior Therapy Solutions of Minnesota | Psychologist | 700 Commerce Dr Ste 260, Woodbury, MN 55125-9243 | 2009-12-04 |
| 1588896310 | Penticoff Community Counseling, Inc. | Psychologist | 1818 Wooddale Dr Ste 204, Woodbury, MN 55125-2983 | 2009-08-12 |
| 1902045669 | Alison Paige Hawkinson | Psychologist | 680 Commerce Dr, Woodbury, MN 55125-4501 | 2009-02-19 |
| 1720294796 | William Joseph Russo | Psychologist | 109 Woodlake Dr W, Woodbury, NY 11797-2308 | 2007-05-15 |
| 1396950523 | Kattar Consulting, PC | Psychologist | 3490 Richmond Pkwy, Woodbury, MN 55129-4914 | 2007-05-11 |
| 1841404555 | Wendy Scarlet Stapen | Psychologist | 56 Orchard Dr, Woodbury, NY 11797-2830 | 2007-05-10 |
| Find all providers in WOODBURY | ||||
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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.