Organization Active NPI

Nobles PSYD LP LLC

  • Counseling Psychologist
  • Saint Paul, MN
National Provider Identifier
1154623593
Registry record updated Jun 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP4435 Issued in MN
Legal business name
NOBLES PSYD LP LLC
Practice address
241 Cleveland Ave S
Suite 2D
Saint Paul, MN 55105-1208
Phone
(651) 698-2326
Fax
(651) 690-0906
NPI assigned
Nov 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2020

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

Authorized official

Name
Yvonne Fernandez Nobles, PSYD
Title
Licensed Psychologist
Phone
(651) 698-2326

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X LP4435 MN Primary

Addresses

Primary practice location

241 Cleveland Ave S
Suite 2D
Saint Paul, MN 55105-1208

Mailing address

241 Cleveland Ave S
Suite 2D
Saint Paul, MN 55105-1208
Phone (651) 698-2326

Other identifiers 1

IdentifierTypeStateIssuer
680001712OtherMNMEDICARE ID-TYPE UNSPECIFIED

National Provider Directory

National Provider Directory

Locations

241 Cleveland Ave S
Ste D2
Saint Paul, MN 55105
Phone (612) 323-2776

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1289952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1154623593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 CLEVELAND AVE S",
            "address_2": "SUITE 2D",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051208",
            "telephone_number": "651-698-2326",
            "fax_number": "651-690-0906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 CLEVELAND AVE S",
            "address_2": "SUITE 2D",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051208",
            "telephone_number": "651-698-2326",
            "fax_number": "651-690-0906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOBLES PSYD LP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-17",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "NOBLES",
        "authorized_official_first_name": "YVONNE",
        "authorized_official_middle_name": "FERNANDEZ",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-698-2326",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP4435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE  UNSPECIFIED",
            "identifier": "680001712",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.