NPIMap

Organization Active NPI

Pinecone Family Counseling, PA

  • Psychologist
  • Sartell, MN
National Provider Identifier
1104094457
Registry record updated Sep 8, 2017
On this page

Key facts

NPPES NPI Registry
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
Last updated
Sep 8, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2017

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., LPNPI 1497846950
Title
Psychologist/Owner
Phone
(320) 253-2385

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X LP3278 MN Primary

Addresses

Primary practice location

2385 Troop Dr.
Suite 202
Sartell, MN 56377

Mailing address

2385 Troop Dr.
Suite 202
Sartell, MN 56377
Phone (320) 253-2385

National Provider Directory

National Provider Directory

Locations

2385 Troop Dr
Unit 202
Sartell, MN 56377
Phone (320) 253-2385

Practitioners & affiliated clinicians

Practitioners 1

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": "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": []
}

Other providers in Sartell, MN

Sources for this page

  • 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.