Northtown Psychology Associates LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

NORTHTOWN PSYCHOLOGY ASSOCIATES LLC

Practice address

199 Coon Rapids Blvd NW Ste 113
Coon Rapids, MN 55433-5859

Phone

(763) 785-8111

Fax

(763) 785-6946

NPI assigned

May 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Gail A Noller, PSYD, LPNPI 1730130758

Title

Psychologist/Co-Owner

Phone

(763) 785-8111

Specialties & licenses 1

Addresses

Other names 1

• Northtown Psychology Associates Other name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 3

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

• Gail Ann Noller, PSYD, LP

  • Psychologist
  • Coon Rapids, MN
  • NPI 1730130758
  Medicare reassignment NPD Authorized official
• Deborah Colleen Miller, PSY.D.

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1417909177
  Medicare reassignment NPD
• Annette Marie Larson, M.A., L.P.C., LADC

  • Mental Health Counselor
  • Coon Rapids, MN
  • NPI 1174972715
  NPD (past)

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1174573067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW STE 113",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335859",
            "telephone_number": "763-785-8111",
            "fax_number": "763-785-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 COON RAPIDS BLVD NW STE 113",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335859",
            "telephone_number": "763-785-8111",
            "fax_number": "763-785-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHTOWN PSYCHOLOGY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A",
        "authorized_official_last_name": "NOLLER",
        "authorized_official_first_name": "GAIL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHOLOGIST/CO-OWNER",
        "authorized_official_telephone_number": "763-785-8111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northtown Psychology Associates",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Northtown Psychology Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Psychologist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.