NPIMap

Organization Active NPI

South Suburban Psychological & Counseling Services, PLLC

  • Clinical Psychologist
  • Eagan, MN
National Provider Identifier
1477859437
Registry record updated Feb 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
SOUTH SUBURBAN PSYCHOLOGICAL & COUNSELING SERVICES, PLLC
Practice address
4635 Nicols Rd
Suite 200
Eagan, MN 55122-3337
Phone
(952) 431-6862
NPI assigned
Feb 8, 2011
Last updated
Feb 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2011

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

Authorized official

Name
Michael James Ferrarese, PH.D., L.P.NPI 1093868747
Title
Psychologist/Owner
Phone
(952) 431-6862

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
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

4635 Nicols Rd
Suite 200
Eagan, MN 55122-3337

Mailing address

4635 Nicols Rd
Suite 200
Eagan, MN 55122-3337
Phone (952) 431-6862

National Provider Directory

National Provider Directory

Locations

4635 Nicols Rd
Ste 200
Saint Paul, MN 55122
Phone (651) 454-0684

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": "1297123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297123200000",
    "number": "1477859437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4635 NICOLS RD",
            "address_2": "SUITE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223337",
            "telephone_number": "952-431-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4635 NICOLS RD",
            "address_2": "SUITE 200",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551223337",
            "telephone_number": "952-431-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SUBURBAN PSYCHOLOGICAL & COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-08",
        "status": "A",
        "authorized_official_last_name": "FERRARESE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PSYCHOLOGIST/OWNER",
        "authorized_official_telephone_number": "952-431-6862",
        "authorized_official_credential": "PH.D., L.P."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagan, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2011; 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.