Susan De Vries, MA, LP

Primary specialty

Family PsychologistTaxonomy code 103TF0000X

License

LP 1035 Issued in MN

Practice address

570 Asbury St
Suite 310
Saint Paul, MN 55104-1849

Phone

(651) 646-7010

Fax

(651) 646-7668

NPI assigned

Mar 12, 2009

Last updated

Mar 12, 2009By the provider in NPPES

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

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1236816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1427299023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 310",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "651-646-7010",
            "fax_number": "651-646-7668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 ASBURY ST",
            "address_2": "SUITE 310",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551041849",
            "telephone_number": "651-646-7010",
            "fax_number": "651-646-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE VRIES",
        "first_name": "SUSAN",
        "credential": "MA, LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-12",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MN",
            "license": "LP 1035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rita Elena Day, RDCS
• Mallory Quinn De Boom, PA
• Amelia Florinda De la O-Peterson, MA, LADC
• Claudia De Llano, D.D.S.
• Sarah Elizabeth De Miglio
• Michelle Mary Dean, DNP
• Nathan Ryan Dean, PH.D., L.P.
• Susan A Dean, LICSW
• Paula C Dearholt, RN, WHCNP
• Grace Deavan

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.