Ignite Child Developmental Services P.a.

Primary specialty

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

Legal business name

IGNITE CHILD DEVELOPMENTAL SERVICES P.A.

Practice address

2448 18TH Ave S
Minneapolis, MN 55404-4006

Phone

(651) 271-7929

NPI assigned

Feb 3, 2020

Organization subpart

No

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

Authorized official

Name

Andy Paulson, PHD, LP

Title

Ceo

Phone

(651) 271-7929

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Kelsey Romero

  • Clinical Social Worker
  • Minneapolis, MN
  • NPI 1457967408
  NPD
• Rebecca Rae Urban, B.A., M.A.

  • Art Therapist
  • Minneapolis, MN
  • NPI 1215542048
  NPD
• Andrew W Paulson, PH.D

  • Psychologist
  • Minneapolis, MN
  • NPI 1184804718
  NPD (past)

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1326679978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 CUNNINGHAM RD",
            "city": "NORTH OAKS",
            "state": "MN",
            "postal_code": "551274300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 18TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554044006",
            "telephone_number": "651-271-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IGNITE CHILD DEVELOPMENTAL SERVICES P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "PAULSON",
        "authorized_official_first_name": "ANDY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-271-7929",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ifteen Autism Center
• Abdirizaq Abshir Igal
• Nadifo Abshir Igal
• Musa Ige
• Ignatia Integrative Therapy PLLC
• Ignite Dental PLLC
• Josephine Akom Igwacho, NURSE PRACTITIONER
• Vivian Mah Igwacho, CNP
• Jacqueline Marie Ihinger
• Zachary Dylan Ihli, NP

• Mental Health Clinic/Center (Including Community Mental Health Center) in Minneapolis, MN
• Providers in Minneapolis, 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 Feb 3, 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.