St. Cloud Neurobehavioral Associates, PA

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

Legal business name

ST. CLOUD NEUROBEHAVIORAL ASSOCIATES, PA

Practice address

3812 8TH St N Ste 200
Saint Cloud, MN 56303-1421

Phone

(320) 253-3833

Fax

(320) 253-5741

NPI assigned

Sep 19, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Annie L Vogel

Title

Office Manager

Phone

(320) 253-3833

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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

• Jeffrey Kearney, PHD, LP

  • Clinical Neuropsychologist
  • Saint Cloud, MN
  • NPI 1962469171
  NPD
• Jessica Louise Lee, PSYD, LP

  • Clinical Psychologist
  • St. Cloud, MN
  • NPI 1982249009
  NPD
• Timothy Ryan Rysavy, PSYD, LP

  • Psychologist
  • St. Cloud, MN
  • NPI 1073052163
  NPD (past)

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

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568851200000",
    "number": "1043860109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 230",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "563770230",
            "telephone_number": "320-253-3833",
            "fax_number": "320-253-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 8TH ST N STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031421",
            "telephone_number": "320-253-3833",
            "fax_number": "320-253-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD NEUROBEHAVIORAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A",
        "authorized_official_last_name": "VOGEL",
        "authorized_official_first_name": "ANNIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-253-3833",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "C03196",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Metropolitan Transit Commission
• St. Cloud Neurobehavioral Associates PA
• St. Cloud Outpatient Surgery, LTD.
• St. Cloud Podiatry Clinic, P.a.
• St. Cloud Rehab LLC
• St. Cloud Silver Lining, Inc
• St. Cloud State University

• Cognitive & Behavioral Psychologist in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Cognitive & Behavioral Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; 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.