Organization Active NPI

Health Care Psychology, PA

  • Clinical Neuropsychologist
  • Forest Lake, MN
National Provider Identifier
1356586457
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
LP1901 Issued in MN
Legal business name
HEALTH CARE PSYCHOLOGY, PA
Practice address
20 Lake St N
Suite 320
Forest Lake, MN 55025-2523
Phone
(651) 464-6900
Fax
(651) 464-6333
NPI assigned
Dec 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Authorized official

Name
Dr. Stanley C Ferneyhough, PH.D
Title
President
Phone
(651) 464-6900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical NeuropsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103G00000X LP1901 MN Primary

Addresses

Primary practice location

20 Lake St N
Suite 320
Forest Lake, MN 55025-2523

Mailing address

20 Lake St N
Suite 320
Forest Lake, MN 55025-2523
Phone (651) 464-6900

National Provider Directory

National Provider Directory

Locations

20 Lake St N
Ste 320
Forest Lake, MN 55025
Phone (651) 464-6900

1310 Highway 96 E
Ste 105
White Bear Lk, MN 55110
Phone (651) 464-6900

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228348800000",
    "number": "1356586457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 LAKE ST N",
            "address_2": "SUITE 320",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252523",
            "telephone_number": "651-464-6900",
            "fax_number": "651-464-6333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 LAKE ST N",
            "address_2": "SUITE 320",
            "city": "FOREST LAKE",
            "state": "MN",
            "postal_code": "550252523",
            "telephone_number": "651-464-6900",
            "fax_number": "651-464-6333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTH CARE PSYCHOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A",
        "authorized_official_last_name": "FERNEYHOUGH",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-464-6900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "MN",
            "license": "LP1901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Lake, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; 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.