Gary P. Liaboe, PHD, LP, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0737 Issued in MN

Legal business name

GARY P. LIABOE, PHD, LP, LLC

Doing business as

Cornerstone Psychological Services

Practice address

3820 Cleveland Ave N
St 400
Arden Hills, MN 55112-3285

Phone

(651) 389-4400

Fax

(651) 389-4410

NPI assigned

Oct 10, 2007

Last updated

Jul 8, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Gary P Liaboe, PH.D., LPNPI 1184722530

Title

President

Phone

(651) 389-4400

Specialties & licenses 1

Addresses

Other identifiers 8

Other names 1

• CORNERSTONE PSYCHOLOGICAL SERVICES Doing business as

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, and the practitioner matching its NPPES authorized official.

• Gary P Liaboe, PH.D.

  • Clinical Psychologist
  • Arden Hills, MN
  • NPI 1184722530
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1164610598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 CLEVELAND AVE N",
            "address_2": "ST 400",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551123285",
            "telephone_number": "651-389-4400",
            "fax_number": "651-389-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 CLEVELAND AVE N",
            "address_2": "ST 400",
            "city": "ARDEN HILLS",
            "state": "MN",
            "postal_code": "551123285",
            "telephone_number": "651-389-4400",
            "fax_number": "651-389-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY P. LIABOE, PHD, LP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "LIABOE",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-389-4400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "324L6CO",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WAUSAU",
            "identifier": "80174310",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "97095547005",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "191366",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHARIORAL HEALTH",
            "identifier": "6142913",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PATIENT CHOICE",
            "identifier": "8017430",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFIC LIFE",
            "identifier": "232253",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005947146",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORNERSTONE PSYCHOLOGICAL SERVICES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yonis Gabow
• Mackenzie Rose Gage
• Natalia Isabel Galindo
• Abigail Grace Gallagher
• Jessica Gapinski
• Alexandra Gebhardt
• Amber Nicole Genetzky, D.C.
• Kirk Jason Gentling
• Ashlyn Kay Gilbertson, PA-S
• Grace Elizabeth Ginter

• Psychologist in Arden Hills, MN
• Providers in Arden Hills, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; 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.