Michael James Tkach, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP6107 Issued in MN

Practice address

680 Stewart Ave
Saint Paul, MN 55102-4117

Phone

(651) 292-2405

NPI assigned

Mar 23, 2017

Sex

Male

Sole proprietor

No

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)

Enrolled

Practice roles

Locations

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.

• Scott M Yarosh, LLC

  • Mental Health Counselor
  • Saint Paul, MN
  • NPI 1144543265
  NPD

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1366973257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 STEWART AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 STEWART AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551024117",
            "telephone_number": "651-292-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TKACH",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PSY.D., LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP6107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madhuri Tirumandas, MD
• Barbara Jane Tisdle, LICSW
• Cassandra Lee Titze
• Gerald Tix
• Jacob Ross Tjernlund, LMFT
• TLC Group Choice
• TLC Nursing Services of Roseville Inc
• TNT Wellness Center
• Wael Toama, MD
• Todd a Thayer DDS Ms PA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; 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.