Mary Elizabeth Grosscup, MA LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3335 Issued in MN

Practice address

5353 Gamble Dr Ste 395
St Louis Park, MN 55416-1510

Phone

(952) 259-1351

Fax

(952) 925-5972

NPI assigned

Jan 14, 2007

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)

Enrolled

Credentials

Master of Arts

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

{
    "created_epoch": "1168732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1558412924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11953 BRADFORD RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553438860",
            "telephone_number": "952-259-1351",
            "fax_number": "952-925-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5353 GAMBLE DR STE 395",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161510",
            "telephone_number": "952-259-1351",
            "fax_number": "952-925-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSCUP",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "MA LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "3335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.