Pinecone Family Counseling, PA

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3278 Issued in MN

Legal business name

PINECONE FAMILY COUNSELING, PA

Practice address

2385 Troop Dr.
Suite 202
Sartell, MN 56377

Phone

(320) 253-2385

Fax

(320) 253-2386

NPI assigned

Feb 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Dorothy Therese Soukup, PH.D., LP

Title

Psychologist/Owner

Phone

(320) 253-2385

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504828800000",
    "number": "1104094457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2385 TROOP DR.",
            "address_2": "SUITE 202",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-253-2385",
            "fax_number": "320-253-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 TROOP DR.",
            "address_2": "SUITE 202",
            "city": "SARTELL",
            "state": "MN",
            "postal_code": "56377",
            "telephone_number": "320-253-2385",
            "fax_number": "320-253-2386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECONE FAMILY COUNSELING, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-20",
        "last_updated": "2017-09-08",
        "status": "A",
        "authorized_official_last_name": "SOUKUP",
        "authorized_official_first_name": "DOROTHY",
        "authorized_official_middle_name": "THERESE",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "320-253-2385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler M Peterson, PA-C
• Christopher Petrie, PSYD, CMPC
• Angela Pfeiffer Bedard, DDS
• Elizabeth A Phillips, MD
• Caitlin Marie Pietrzak
• Pinecone Vision Center
• Pinecone Vision Center, PA
• Pinecone Vision Therapy Center
• Lori Ann Pinke, MD
• Clarissa Josephine Piwowar

• All providers in Sartell, MN
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2017; 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.