Life-Work Psychotherapy LLC

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

Legal business name

LIFE-WORK PSYCHOTHERAPY LLC

Practice address

333 Grand Ave Ste 102
Saint Paul, MN 55102-2584

Phone

(651) 571-8967

Fax

(651) 666-1592

NPI assigned

Sep 30, 2024

Organization subpart

No

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

Authorized official

Name

William Scott Slattery, PHDNPI 1689797136

Title

Owner

Phone

(612) 386-9682

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

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

• William Scott Slattery, PH.D.

  • Counseling Psychologist
  • Saint Paul, MN
  • NPI 1689797136
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1366260341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 FORD PKWY",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551162208",
            "telephone_number": "612-386-9682",
            "fax_number": "651-666-1592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 GRAND AVE STE 102",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022584",
            "telephone_number": "651-571-8967",
            "fax_number": "651-666-1592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE-WORK PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "SLATTERY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-386-9682",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS; HEALTHPARTNERS; UCARE",
            "identifier": "1689797136",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.