Practical Therapy LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

13825 Issued in MN

Legal business name

PRACTICAL THERAPY LLC

Practice address

570 Asbury St
Suite 206
Saint Paul, MN 55104-1849

Phone

(612) 760-7818

Fax

(651) 212-4149

NPI assigned

Aug 21, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Jeanne Lynn Fischer, MSWNPI 1740401298

Title

Licsw, Owner

Phone

(612) 760-7818

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeanne Lynn Fischer, MSW, LICSW

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1740401298
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1408579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408579200000",
    "number": "1134528557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 206",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "612-760-7818",
            "fax_number": "651-212-4149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 206",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "612-760-7818",
            "fax_number": "651-212-4149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRACTICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-21",
        "last_updated": "2014-08-21",
        "status": "A",
        "authorized_official_last_name": "FISCHER",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "LICSW, OWNER",
        "authorized_official_telephone_number": "612-760-7818",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "13825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "246900600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon Giordano Powers
• Sophie Lynn Poynter
• Linda Agnes Pozen, MSW, LGSW
• PPSM
• Sapna Prabhakaran, M.D
• Andrea Sue Prado
• Prairie Horizons Health Inc
• Prairie Path Behavioral Health LLC
• Prairie St. John'S Clinic
• Prairiestone Pharmacy LLC

• Community/Behavioral Health Agency in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.