Clinical and Developmental Services LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

5460 Issued in MN

Legal business name

CLINICAL AND DEVELOPMENTAL SERVICES LLC

Practice address

9384 Oak Ave
Waconia, MN 55387-9422

Phone

(952) 923-8001

Fax

(952) 955-6213

NPI assigned

Dec 23, 2013

Last updated

Dec 23, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Clayton Joseph Egli, PH.D.NPI 1154699015

Title

Licensed Psychologist

Phone

(952) 923-8001

Specialties & licenses 1

Addresses

Locations

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.

• Clayton Joseph Egli, PH.D.

  • Clinical Psychologist
  • Waconia, MN
  • NPI 1154699015
  NPD Authorized official

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

{
    "created_epoch": "1387756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387756800000",
    "number": "1346661063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9384 OAK AVE",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879422",
            "telephone_number": "952-923-8001",
            "fax_number": "952-955-6213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9384 OAK AVE",
            "city": "WACONIA",
            "state": "MN",
            "postal_code": "553879422",
            "telephone_number": "952-923-8001",
            "fax_number": "952-955-6213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL AND DEVELOPMENTAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-23",
        "last_updated": "2013-12-23",
        "status": "A",
        "authorized_official_last_name": "EGLI",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "952-923-8001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "5460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Christensen
• Ryan Christenson, D.C.
• Anne Christiansen, MD
• Anna Ciliske
• Patrick Jeremiah Clark, MSW
• CMT Anesthesia LLC
• Jackie L Collins, CNP
• Gary R Comfort, CRNA
• Karissa Lyn Conforte
• Nancy K Cooley, M.D.

• Clinical Psychologist in Waconia, MN
• Providers in Waconia, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.