NPIMap

Organization Active NPI

Simonson Psychological Services

  • Psychologist
  • Blaine, MN
National Provider Identifier
1407907397
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3450 Issued in MN
Legal business name
SIMONSON PSYCHOLOGICAL SERVICES
Practice address
10267 University Ave
#203
Blaine, MN 55434
Phone
(763) 639-7462
Fax
(763) 786-5462
NPI assigned
Jan 16, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Daniel Paul Simonson, MS LPNPI 1659036416
Title
President Psychologist
Phone
(763) 639-7462

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X 3450 MN Primary

Addresses

Primary practice location

10267 University Ave
#203
Blaine, MN 55434

Mailing address

10267 University Ave NE
Suite 203
Blaine, MN 55434
Phone (763) 639-7462

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407907397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10267 UNIVERSITY AVE NE",
            "address_2": "SUITE 203",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-639-7462",
            "fax_number": "763-786-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10267 UNIVERSITY AVE",
            "address_2": "#203",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "55434",
            "telephone_number": "763-639-7462",
            "fax_number": "763-786-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMONSON PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SIMONSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT PSYCHOLOGIST",
        "authorized_official_telephone_number": "763-639-7462",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MS LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "3450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blaine, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.