Organization Active NPI

Encompass Integrative Health, LLC

  • Clinical Psychologist
  • Elk River, MN
National Provider Identifier
1023608254
Registry record updated Jan 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
ENCOMPASS INTEGRATIVE HEALTH, LLC
Practice address
19230 Evans St NW Ste 109
Elk River, MN 55330-1079
Phone
(952) 232-6054
Fax
(952) 232-6350
NPI assigned
Jan 21, 2021
Last updated
Jan 2, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2023

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

Authorized official

Name
Rebecca Fischer, PSYD, LPNPI 1326371246
Title
Co Owner
Phone
(715) 497-6802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

19230 Evans St NW Ste 109
Elk River, MN 55330-1079

Mailing address

19230 Evans St NW Ste 109
Elk River, MN 55330-1079
Phone (952) 232-6054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230609000555 MN Part B Supplier - Clinic/Group Practice 1557728318 Receives reassigned benefits from 4 practitioners
Practice locations: Elk River, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1023608254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19230 EVANS ST NW STE 109",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301079",
            "telephone_number": "952-232-6054",
            "fax_number": "952-232-6350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19230 EVANS ST NW STE 109",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301079",
            "telephone_number": "952-232-6054",
            "fax_number": "952-232-6350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCOMPASS INTEGRATIVE HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-21",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "CO OWNER",
        "authorized_official_telephone_number": "715-497-6802",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk River, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; 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.