Active NPI
Ritamarie Risley Balcerzak, M.A.
- Psychologist
- White Bear Lake, MN
National Provider Identifier
1104955418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP1726
- Practice address
- 2186 3Rd St
Suite 105
White Bear Lake, MN 55110-3263 - Phone
- (651) 227-8880
- Fax
- (651) 227-8908
- NPI assigned
- Mar 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP1726 | MN | Primary |
Addresses
Primary practice location
2186 3Rd St
Suite 105
White Bear Lake, MN 55110-3263
Mailing address
2186 3Rd St
Suite 105
White Bear Lake, MN 55110-3263
Phone (651) 227-8880
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 546547800 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP1726 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psychological&Behavioralconsultantspa | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Psychologist
- White Bear Lake, MN
- NPI 1811026123
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172966400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1361836800000",
"number": "1104955418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2186 3RD ST",
"address_2": "SUITE 105",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551103263",
"telephone_number": "651-227-8880",
"fax_number": "651-227-8908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2186 3RD ST",
"address_2": "SUITE 105",
"city": "WHITE BEAR LAKE",
"state": "MN",
"postal_code": "551103263",
"telephone_number": "651-227-8880",
"fax_number": "651-227-8908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALCERZAK",
"first_name": "RITAMARIE",
"middle_name": "RISLEY",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-04",
"last_updated": "2013-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP1726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "546547800",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in White Bear Lake, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.