Organization Active NPI

Behavioral Health Associates, LTD.

  • Intellectual & Developmental Disabilities Psychologist
  • Moorhead, MN
National Provider Identifier
1104128156
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
License
A470016300 Issued in MN
Legal business name
BEHAVIORAL HEALTH ASSOCIATES, LTD.
Practice address
1132 28TH Ave S
Suite 105a
Moorhead, MN 56560-4420
Phone
(800) 246-9036
Fax
(888) 688-4095
NPI assigned
Nov 24, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Mr. Jeffrey Lundquist
Title
Administrative Director
Phone
(800) 246-9036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TM1800X A470016300 MN Primary

Addresses

Primary practice location

1132 28TH Ave S
Suite 105a
Moorhead, MN 56560-4420

Mailing address

PO Box 40
Paynesville, MN 56362-0040
Phone (800) 246-9036

National Provider Directory

National Provider Directory

Locations

1132 28th Ave S
Ste 105A
Moorhead, MN 56560
Phone (800) 246-9036

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": "1290556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1104128156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "PAYNESVILLE",
            "state": "MN",
            "postal_code": "563620040",
            "telephone_number": "800-246-9036",
            "fax_number": "888-688-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1132 28TH AVE S",
            "address_2": "SUITE 105A",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565604420",
            "telephone_number": "800-246-9036",
            "fax_number": "888-688-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEHAVIORAL HEALTH ASSOCIATES, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-24",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "LUNDQUIST",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "ADMINISTRATIVE DIRECTOR",
        "authorized_official_telephone_number": "800-246-9036",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "MN",
            "license": "A470016300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moorhead, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.