NPIMap

Organization Active NPI

Treehouse Psychology, PLLC

  • Clinical Psychologist
  • Shoreview, MN
National Provider Identifier
1417220104
Registry record updated Feb 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP5296 Issued in MN
Legal business name
TREEHOUSE PSYCHOLOGY, PLLC
Practice address
500 Highway 96 W
Suite 400
Shoreview, MN 55126-1944
Phone
(651) 243-1513
Fax
(651) 203-7370
NPI assigned
Feb 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2012

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

Authorized official

Name
Stefanie Varga, PHD
Title
Owner, Clinical Psychologist
Phone
(651) 243-1513

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X LP5296 MN Primary

Addresses

Primary practice location

500 Highway 96 W
Suite 400
Shoreview, MN 55126-1944

Mailing address

500 Highway 96 W Ste 400
Shoreview, MN 55126-1959
Phone (651) 243-1513

National Provider Directory

National Provider Directory

Locations

500 Highway 96 W
Ste 400
Shoreview, MN 55126
Phone (651) 243-1513

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1328918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1328918400000",
    "number": "1417220104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 HIGHWAY 96 W STE 400",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261959",
            "telephone_number": "651-243-1513",
            "fax_number": "651-203-7370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HIGHWAY 96 W",
            "address_2": "SUITE 400",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551261944",
            "telephone_number": "651-243-1513",
            "fax_number": "651-203-7370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREEHOUSE PSYCHOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-11",
        "last_updated": "2012-02-11",
        "status": "A",
        "authorized_official_last_name": "VARGA",
        "authorized_official_first_name": "STEFANIE",
        "authorized_official_title_or_position": "OWNER, CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-243-1513",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreview, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2012; 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.