Laraine Patricia Kurisko, PH.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4466 Issued in MN

Practice address

4005 West 65TH Street
Suite 104
Edina, MN 55435

Phone

(952) 926-2424

Fax

(952) 926-3454

NPI assigned

Oct 3, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104911676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18664 OVERLAND TRAIL",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474186",
            "telephone_number": "952-974-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 WEST 65TH STREET",
            "address_2": "SUITE 104",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "55435",
            "telephone_number": "952-926-2424",
            "fax_number": "952-926-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KURISKO",
        "first_name": "LARAINE",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryann Michelle Kujawa Thompson
• Amanda Kujawa, MS
• Kedar Kulkarni, M.D.
• Rachel Grace Kullas
• Amy Kulus, OTR/L
• Randee Marie Kurten, MS, ATC
• Brett J Kurtzman, D.D.S.
• Thomas Nicholas Kurvers, M.D.
• Miranda Mae Kuschel
• Christina Anne Kuzas, OD

• Clinical Psychologist in Edina, MN
• Providers in Edina, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.