Twin Cities Behavioral Health, PC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

LP4413 Issued in MN

Legal business name

TWIN CITIES BEHAVIORAL HEALTH, PC

Practice address

7300 Metro Blvd
Suite 635
Edina, MN 55439-2303

Phone

(952) 831-3662

Fax

(952) 831-3559

NPI assigned

Apr 28, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Joseph I Shagalow, PSYD LPNPI 1164520284

Title

Owner/Officer

Phone

(952) 831-3662

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Tax ID family

Twin Cities Behavioral Health PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Twin Cities Behavioral Health PC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Buffalo, MN
  • NPI 1013311802
  NPD tax ID
• Twin Cities Behavioral Health, PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Buffalo, MN
  • NPI 1659674489
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Shagalow, PSYD LP

  • Psychologist
  • Edina, MN
  • NPI 1164520284
  Medicare reassignment NPD Authorized official
• Nechama Layah Shagalow, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1982372256
  NPD

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1295979664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 METRO BLVD",
            "address_2": "SUITE 635",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392303",
            "telephone_number": "952-831-3662",
            "fax_number": "952-831-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7300 METRO BLVD",
            "address_2": "SUITE 635",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554392303",
            "telephone_number": "952-831-3662",
            "fax_number": "952-831-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWIN CITIES BEHAVIORAL HEALTH, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "SHAGALOW",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER/OFFICER",
        "authorized_official_telephone_number": "952-831-3662",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD LP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "LP4413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164520284",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TWC Mobility LLC
• Kathryn Tweed, MPH, PA-C
• Madison Tweed, LPCC, LADC
• Jeffry John Twidwell, M.D.
• Twin Cities Anesthesia, P.a.
• Twin Cities Cardiology
• Twin Cities Cognitive Behavioral Treatment Center, LLC
• Twin Cities Pain Clinic Transportation, Inc.
• Twin Cities Pain Management, PLLC
• Twin Cities Spine & Sports, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Edina, MN
• Providers in Edina, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.