SDR Psychiatry LLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24545 Issued in MN

Legal business name

SDR PSYCHIATRY LLC

Practice address

5200 Willson Rd
#405
Edina, MN 55424-1332

Phone

(612) 310-9960

Fax

(612) 872-2205

NPI assigned

Jun 3, 2013

Organization subpart

No

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

Authorized official

Name

Silvia Divinetz Romero, MD

Title

Psychiatrist

Phone

(612) 872-1500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370217600000",
    "number": "1215374954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 24062",
            "address_2": "3948 W 49 1/2 STREET",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554240062",
            "telephone_number": "612-872-1500",
            "fax_number": "612-872-2205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 WILLSON RD",
            "address_2": "#405",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554241332",
            "telephone_number": "612-310-9960",
            "fax_number": "612-872-2205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SDR PSYCHIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-03",
        "last_updated": "2013-06-03",
        "status": "A",
        "authorized_official_last_name": "ROMERO",
        "authorized_official_first_name": "SILVIA",
        "authorized_official_middle_name": "DIVINETZ",
        "authorized_official_title_or_position": "PSYCHIATRIST",
        "authorized_official_telephone_number": "612-872-1500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MN",
            "license": "24545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Joy Schwenke, M.A., PHD
• Robert L Sciulli, MD
• Grace Orianda Scott
• Meredith Rae Scott
• Naomi Scott, PSY.D., L.P.
• Meagen Seabul
• Benjamin Seckler, MD
• Marcia Michele Seebachan, LCSW
• Seed Home Healthcare LLC
• Ira Scott Segal, M.D.

• Psychiatry Physician in Edina, MN
• Providers in Edina, MN by specialty
• Psychiatry Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2013; 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.