NPIMap

Organization Active NPI

Associated Counseling Services, PLLC

  • Forensic Psychologist
  • Little Canada, MN
National Provider Identifier
1093859332
Registry record updated Feb 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
LP1096 Issued in MN
Legal business name
ASSOCIATED COUNSELING SERVICES, PLLC
Practice address
2625 Edgerton St
Little Canada, MN 55117-1620
Phone
(651) 484-1544
Fax
(651) 415-1337
NPI assigned
Feb 19, 2007
Last updated
Feb 1, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2011

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

Authorized official

Name
Dr. Gail Rose Maudal, PH.D., L.P.NPI 1669640983
Title
President
Phone
(651) 484-1544

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
Forensic Psychologist 103TF0200X LP1096 MN Primary

Addresses

Primary practice location

2625 Edgerton St
Little Canada, MN 55117-1620

Mailing address

2625 Edgerton St
Little Canada, MN 55117-1620
Phone (651) 484-1544

Other identifiers 1

IdentifierTypeStateIssuer
1093859332OtherMNNPI

Other names 1

  • Associated Counseling Services, Inc. Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296518400000",
    "number": "1093859332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 EDGERTON ST",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171620",
            "telephone_number": "651-484-1544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 EDGERTON ST",
            "city": "LITTLE CANADA",
            "state": "MN",
            "postal_code": "551171620",
            "telephone_number": "651-484-1544",
            "fax_number": "651-415-1337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASSOCIATED COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2011-02-01",
        "status": "A",
        "authorized_official_last_name": "MAUDAL",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-484-1544",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., L.P."
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MN",
            "license": "LP1096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1093859332",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Associated Counseling Services, Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Little Canada, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2011; 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.