Nathaniel Page, PHD, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6093 Issued in MN

Practice address

2423 Valley Dr
Northfield, MN 55057-3224

Phone

(801) 471-8851

NPI assigned

Oct 18, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Group Therapy Central

  dba Northfield Dynamic Therapy

  • Psychologist
  • Northfield, MN
  • NPI 1619868338
  NPD Authorized official

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

{
    "created_epoch": "1571356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571356800000",
    "number": "1083257349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 VALLEY DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573224",
            "telephone_number": "801-471-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 VALLEY DR",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550573224",
            "telephone_number": "801-471-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAGE",
        "first_name": "NATHANIEL",
        "name_prefix": "Dr.",
        "credential": "PHD, LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-10-18",
        "last_updated": "2019-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nate@grouptherapycentral.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2423 Valley Dr",
            "city": "Northfield",
            "state": "MN",
            "country_code": "US",
            "postal_code": "550573224",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Omada, Inc. (Omada Behavioral Health Services)
• Katelyn May Opperman
• Orthotic Care Services, LLC
• Adam Ozmun, PHARMD
• Laura Jane Page, PH.D., LP
• Patricia Richardson MSW, Licsw, LMFT, LTD
• Paula J. Detjen, PLLC
• Pediatric and Young Adult Care
• Nancy Ann Pelegano
• Jeanne Marie Peloquin, PT

• Psychologist in Northfield, MN
• Providers in Northfield, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.