Charles Gerald Depies, PSYD LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2960 Issued in MN

Practice address

2220 Riverside Ave S
Mail Stop 31700a
Minneapolis, MN 55454-1321

Phone

(612) 371-1600

Fax

(612) 371-1732

NPI assigned

Feb 17, 2006

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

Other identifiers 1

Other names 1

• Chuck Depies Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Interoperability endpoints

• Direct secure messaging: cdepies68239@excellian.direct.allina.com

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1457325136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 34TH AVE S",
            "address_2": "21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554251672",
            "telephone_number": "952-883-7961",
            "fax_number": "952-883-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 RIVERSIDE AVE S",
            "address_2": "MAIL STOP 31700A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541321",
            "telephone_number": "612-371-1600",
            "fax_number": "612-371-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPIES",
        "first_name": "CHARLES",
        "middle_name": "GERALD",
        "credential": "PSYD  LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "2960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "190217200",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cdepies68239@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CPA/PDF/TXT",
            "address_1": "1021 Bandana Blvd E Ste 100",
            "city": "Saint Paul",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551085109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHUCK",
            "last_name": "DEPIES",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jeri L Dentz, CNM
• Daniel Joseph Denucci, DDS
• Kedar Jayant Deogaonkar, M.D.
• Department of Veteran Affairs
• Department of Veterans Affairs
• Amy Carolyn Theis Depoint, L.AC.
• Olivia Deponty
• Christine Marie Dequaine, LSW
• Keith Leslie Deraad, CPRP
• Amanda Kay Derasmi, DO

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, 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 11, 2021; 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.