Stephen M. Hjemboe, PH.D., LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3086 Issued in MN

Legal business name

STEPHEN M. HJEMBOE, PH.D., LLC

Practice address

570 Asbury St
Suite 208
Saint Paul, MN 55104-1849

Phone

(651) 776-2648

Fax

(651) 778-1458

NPI assigned

Mar 14, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Stephen Mark Hjemboe, PH.D.

Title

Proprietor

Phone

(651) 776-2648

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• St. Paul Psychology Other name

Locations

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

{
    "created_epoch": "1300060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1013215136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 BATES AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066339",
            "telephone_number": "651-776-2648",
            "fax_number": "651-778-1458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 208",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "651-776-2648",
            "fax_number": "651-778-1458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN M. HJEMBOE, PH.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-14",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "HJEMBOE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "651-776-2648",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3086",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "705714800",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEAL THPARTNERS",
            "identifier": "HP22394",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Paul Psychology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.