Organization Active NPI

Center for Personal & Professional Growth, LLC

  • Psychologist
  • Rochester, MN
National Provider Identifier
1063519262
Registry record updated Jun 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP3327 Issued in MN
Legal business name
CENTER FOR PERSONAL & PROFESSIONAL GROWTH, LLC
Practice address
400 S Broadway
Ste 16
Rochester, MN 55904
Phone
(507) 252-5700
Fax
(507) 252-8115
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2008

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

Authorized official

Name
Victoria Volstad, MS LPNPI 1982701181
Title
Owner
Phone
(507) 252-5700

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
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X LP3327 MN Primary

Addresses

Primary practice location

400 S Broadway
Ste 16
Rochester, MN 55904

Mailing address

400 S Broadway
Ste 16
Rochester, MN 55904
Phone (507) 252-5700

Other identifiers 1

IdentifierTypeStateIssuer
806023100MedicaidMN

National Provider Directory

National Provider Directory

Locations

400 Broadway Ave S
Ste 16
Rochester, MN 55904
Phone (507) 252-5700

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1063519262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY",
            "address_2": "STE 16",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55904",
            "telephone_number": "507-252-5700",
            "fax_number": "507-252-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S BROADWAY",
            "address_2": "STE 16",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "55904",
            "telephone_number": "507-252-5700",
            "fax_number": "507-252-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR PERSONAL & PROFESSIONAL GROWTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "VOLSTAD",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "507-252-5700",
        "authorized_official_credential": "MS LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806023100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; 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.