Nicholas Lee Starr, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP5294 Issued in MN

Practice address

900 5TH St Ste 305
International Falls, MN 56649-2200

Phone

(218) 283-3406

NPI assigned

Sep 8, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Northland Counseling Center, Inc.

  • Community/Behavioral Health Agency
  • Grand Rapids, MN
  • NPI 1164610986
  NPD (past)
• Northland Recovery Pineview Center

  • Substance Abuse Rehabilitation Facility
  • Littlefork, MN
  • NPI 1588110530
  NPD (past)

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

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283904000000",
    "number": "1104133586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 5TH ST STE 305",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 5TH ST STE 305",
            "city": "INTERNATIONAL FALLS",
            "state": "MN",
            "postal_code": "566492200",
            "telephone_number": "218-283-3406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARR",
        "first_name": "NICHOLAS",
        "middle_name": "LEE",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "322853300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shailynn Nicole Shipley, APRN, CNP
• Roxanne Tillie Skogstad-Ditsch, M.ED., N.A.D.-III, L
• Jesse Allan Skogstad I, PHARMD
• Jenny Skoog, PTA
• Tim Allen Smith, M.D.
• Anthony Christian Stone
• Doreen Evonne Swendsen, FNP
• Justin J Taylor
• The Duluth Clinic, LTD
• The Evangelical Lutheran Good Samaritan Society

• Psychologist in International Falls, MN
• Providers in International Falls, MN by specialty
• Psychologist in Minnesota

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