Suzanne Gayle Wenstrom Pocrnich, M.S., L.P.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

LP3820 Issued in MN

Practice address

133 2ND Ave SW
Cambridge, MN 55008-1552

Phone

(763) 689-9407

NPI assigned

Apr 6, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Based Therapy Associates

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1194762005
  NPD (past)

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053434159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 307TH TRL NE",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550086016",
            "telephone_number": "763-444-7068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 2ND AVE SW",
            "city": "CAMBRIDGE",
            "state": "MN",
            "postal_code": "550081552",
            "telephone_number": "763-689-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENSTROM POCRNICH",
        "first_name": "SUZANNE",
        "middle_name": "GAYLE",
        "name_prefix": "Ms.",
        "credential": "M.S., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP3820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walker Methodist Levande LLC (Walker Methodist Levande)
• Daniel Charles Wallace, M.D.
• Randall Dean Wallace, M.S.
• Walmart Inc. (Walmart Pharmacy 10-2352)
• Timothy Michael Wendel Jr., NP
• Nicole Marie Westensee, ATC
• Westerberg Chiropractic P.a.
• Randall Douglas Westerberg, D.C.
• Elizabeth Westphal
• Ashley Nicole Wilkens, PT

• Counseling Psychologist in Cambridge, MN
• Providers in Cambridge, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.