NPIMap

Organization Active NPI

Community Psychology of Minnesota, LLC

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1326343088
Registry record updated Jan 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
4383 Issued in MN
Legal business name
COMMUNITY PSYCHOLOGY OF MINNESOTA, LLC
Practice address
1895 Laurel Ave
Saint Paul, MN 55104-5938
Phone
(651) 647-4944
Fax
(651) 646-6176
NPI assigned
Jan 11, 2011
Last updated
Jan 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2011

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

Authorized official

Name
Mr. Bradley Lee Kinder, L.P., L.M.F.T.NPI 1497892467
Title
Ceo
Phone
(651) 647-4944

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 4383 MN Primary
Marriage & Family Therapist 106H00000X 392 MN

Addresses

Primary practice location

1895 Laurel Ave
Saint Paul, MN 55104-5938

Mailing address

1895 Laurel Ave
Saint Paul, MN 55104-5938
Phone (651) 647-4944

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1294704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294704000000",
    "number": "1326343088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1895 LAUREL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045938",
            "telephone_number": "651-647-4944",
            "fax_number": "651-646-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1895 LAUREL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551045938",
            "telephone_number": "651-647-4944",
            "fax_number": "651-646-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY PSYCHOLOGY OF MINNESOTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-11",
        "last_updated": "2011-01-11",
        "status": "A",
        "authorized_official_last_name": "KINDER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-647-4944",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.P., L.M.F.T."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "4383",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "392",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; 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.