Raye McPhillips Eyrich, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0348 Issued in MN

Practice address

825 Nicollet Mall
Suite 612
Minneapolis, MN 55402-2606

Phone

(612) 203-8660

Fax

(612) 659-1906

NPI assigned

Aug 9, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 19, 2021 through Jul 19, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1215938659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4721 HARRIET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554195433",
            "telephone_number": "612-822-1932",
            "fax_number": "612-659-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 NICOLLET MALL",
            "address_2": "SUITE 612",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554022606",
            "telephone_number": "612-203-8660",
            "fax_number": "612-659-1906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EYRICH",
        "first_name": "RAYE",
        "middle_name": "MCPHILLIPS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0348",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0063709200",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.