Center for Psychological Growth and Resilience

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

CENTER FOR PSYCHOLOGICAL GROWTH AND RESILIENCE

Practice address

4317 Upton Ave S Ste a
Minneapolis, MN 55410-1540

Phone

(952) 222-8162

NPI assigned

Dec 22, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dennis Hannon, PSYD, LPNPI 1447762869

Title

Chief Executive Officer

Phone

(952) 222-8162

Specialties & licenses 1

Addresses

Other names 1

• CPGR Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dennis Hannon, PSYD

  • Psychologist
  • Minneapolis, MN
  • NPI 1447762869
  Medicare reassignment Care Compare group NPD Authorized official
• Theresa Hinnenkamp Lienau, PSYD, LP

  • Psychologist
  • Edina, MN
  • NPI 1609528090
  Medicare reassignment Care Compare group NPD
• Ashley Elizabeth Schultz Henricksen, LICSW

  • Clinical Social Worker
  • Edina, MN
  • NPI 1417413501
  Medicare reassignment NPD
• Mych-Jarrod Dallozzi, PSYD, NCC, LPCC

  • Counseling Psychologist
  • Minneapolis, MN
  • NPI 1558828251
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712793600000",
    "number": "1003576653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 UPTON AVE S STE A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101540",
            "telephone_number": "952-222-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 UPTON AVE S STE A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101540",
            "telephone_number": "952-222-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PSYCHOLOGICAL GROWTH AND RESILIENCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-22",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A",
        "authorized_official_last_name": "HANNON",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "952-222-8162",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.dennis.hannon@cpgrpsych.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email",
            "address_1": "4317 Upton Ave S Ste A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554101540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "CPGR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CPGR",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.