Organization Active NPI

Wellpsych Mental Health, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Eagan, MN
National Provider Identifier
1184474504
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
WELLPSYCH MENTAL HEALTH, PLLC
Practice address
3005 Eagandale PL Apt 119
Eagan, MN 55121-2120
Phone
(612) 552-1748
NPI assigned
Mar 26, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Authorized official

Name
Millicent Boa-Amponsem, NP
Title
Director
Phone
(612) 552-1748

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3005 Eagandale PL Apt 119
Eagan, MN 55121-2120

Mailing address

2136 Ford Pkwy # 9008
Saint Paul, MN 55116-2850
Phone (612) 552-1748

Other names 1

  • WellPsych Mental Health, PLLC Doing business as

National Provider Directory

National Provider Directory

Locations

2136 Ford Pkwy
#9008
Saint Paul, MN 55116

NPI Registry JSON

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

{
    "created_epoch": "1711411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711411200000",
    "number": "1184474504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 FORD PKWY # 9008",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162850",
            "telephone_number": "612-552-1748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 EAGANDALE PL APT 119",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551212120",
            "telephone_number": "612-552-1748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLPSYCH MENTAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-26",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A",
        "authorized_official_last_name": "BOA-AMPONSEM",
        "authorized_official_first_name": "MILLICENT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "612-552-1748",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WellPsych Mental Health, PLLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2024; 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.