Family Therapy & Recovery Ctr

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP1366 Issued in MN

Legal business name

FAMILY THERAPY & RECOVERY CTR

Practice address

5353 Gamble Dr
Suite 108
St Louis Park, MN 55416-1539

Phone

(952) 545-8833

NPI assigned

Aug 19, 2006

Organization subpart

No

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

Authorized official

Name

Sharon Kaye Ondich, PHD LP

Title

President

Phone

(952) 545-8833

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275647604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5353 GAMBLE DR",
            "address_2": "SUITE 108",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161539",
            "telephone_number": "952-545-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 GAMBLE DR",
            "address_2": "SUITE 108",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161539",
            "telephone_number": "952-545-8833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY THERAPY & RECOVERY CTR",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ONDICH",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "KAYE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "952-545-8833",
        "authorized_official_credential": "PHD LP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN CARE",
            "identifier": "121015",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSIMN",
            "identifier": "7H008FA",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.