Phyllis White Phelan, PH.D.

Primary specialty

Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X

License

LP1119 Issued in MN

Practice address

570 Asbury St
Suite 302
Saint Paul, MN 55104-1849

Phone

(651) 644-5275

Fax

(763) 201-1095

NPI assigned

Jul 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ralph a. Rovner, PH.D., P.a.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1487665014
  NPD (past)

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366649386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 302",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "651-644-5275",
            "fax_number": "763-201-1095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 302",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "651-644-5275",
            "fax_number": "763-201-1095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHELAN",
        "first_name": "PHYLLIS",
        "middle_name": "WHITE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "LP1119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therese Pham
• Truc Thanh Pham, RDH, DT
• Peter Phan
• Vincent Phan
• Neil P Phelan, M.D.
• Phenomix Sciences LLC
• Khammany Phetsavong
• Chanhderg Philavanh
• Ann M Philbrick, PHARM.D.
• Gaile Kristine Philipp

• Cognitive & Behavioral Psychologist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Cognitive & Behavioral Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.