Susan D Hembroff, MA, LP, LMFT

Primary specialty

PsychologistTaxonomy code 103T00000X

License

4656 Issued in MN

Practice address

5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322

Phone

(763) 569-5200

Fax

(763) 569-5201

NPI assigned

May 19, 2006

Last updated

Jul 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Susan D Flemming Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Youable Emotional Health Services

  • Community/Behavioral Health Agency
  • Richfield, MN
  • NPI 1386728228
  NPD

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1578517173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Decatur Ave N Ste 109",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554274363",
            "country_code": "US",
            "telephone_number": "763-746-2400",
            "fax_number": "763-746-2401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6425 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554231675",
            "country_code": "US",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEMBROFF",
        "first_name": "SUSAN",
        "middle_name": "D",
        "credential": "MA, LP, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "4656",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "LMFT1043",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "FLEMMING",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Psychologist in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.