Stacey Marie Desouza

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

102928 Issued in MN

Practice address

360 Sherman St
470
Saint Paul, MN 55102-2564

Phone

(651) 209-6520

Fax

(651) 209-6521

NPI assigned

Jun 4, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Minnesota Spine Rehab, Inc

  • Occupational Medicine Clinic/Center
  • Saint Paul, MN
  • NPI 1043236896
  NPD (past)

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1295172914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 SHERMAN ST STE 470",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022988",
            "telephone_number": "651-209-6520",
            "fax_number": "651-209-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 SHERMAN ST",
            "address_2": "470",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022564",
            "telephone_number": "651-209-6520",
            "fax_number": "651-209-6521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESOUZA",
        "first_name": "STACEY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MN",
            "license": "102928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daena Desjardins, MASSAGE THERAPIST
• Lisa Marie Deslauriers
• Russell C Desmarais, DC, DABCI
• Cheri Ann Desmond-May, MSW, MAED, LP
• Laura Desouza, LICSW
• Nancy Dessert, M.D.
• Mark T Destache, MD
• John Armen Desteian, JD, DPSY
• Tera Marie Detels, LGSW
• Jessica Determan, CPNP

• Occupational Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.