NPIMap

Organization Active NPI

Elizabeth a. Buhl, Psy.D., LP, LLC

  • Psychologist
  • Saint Cloud, MN
National Provider Identifier
1306123187
Registry record updated Nov 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP4637 Issued in MN
Legal business name
ELIZABETH A. BUHL, PSY.D., LP, LLC
Practice address
600 25TH Ave S
Suite 109 Roosevelt Office Park
Saint Cloud, MN 56301-4841
Phone
(320) 255-0343
Fax
(320) 654-0318
NPI assigned
Nov 8, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2011

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

Authorized official

Name
Elizabeth A Buhl, PSY.D., LPNPI 1750326401
Title
Psychologist
Phone
(320) 493-3664

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X LP4637 MN Primary
Community/Behavioral Health Agency 251S00000X LP4637 MN

Addresses

Primary practice location

600 25TH Ave S
Suite 109 Roosevelt Office Park
Saint Cloud, MN 56301-4841

Mailing address

600 25TH Ave S
Suite 109 Roosevelt Office Park
Saint Cloud, MN 56301-4841
Phone (320) 255-0343

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120323000218 MN Part B Supplier - Clinic/Group Practice 7214197508 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Cloud, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1320710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320710400000",
    "number": "1306123187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S",
            "address_2": "SUITE 109 ROOSEVELT OFFICE PARK",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014841",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 25TH AVE S",
            "address_2": "SUITE 109 ROOSEVELT OFFICE PARK",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014841",
            "telephone_number": "320-255-0343",
            "fax_number": "320-654-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH A. BUHL, PSY.D., LP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-08",
        "last_updated": "2011-11-08",
        "status": "A",
        "authorized_official_last_name": "BUHL",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "320-493-3664",
        "authorized_official_credential": "PSY.D., LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP4637",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP4637",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2011; 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.