Active NPI
June Sroufe, PH.D, L.P.
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1578604153
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2274
- Practice address
- 2904 Humboldt Ave S
Minneapolis, MN 55408-1953 - Phone
- (612) 872-9837
- NPI assigned
- Feb 8, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2274 | MN | Primary |
Addresses
Primary practice location
2904 Humboldt Ave S
Minneapolis, MN 55408-1953
Mailing address
4808 Lyndale Ave S
Minneapolis, MN 55419-5363
Phone (612) 872-9837
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2274 | MN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578604153",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4808 LYNDALE AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554195363",
"telephone_number": "612-872-9837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2904 HUMBOLDT AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554081953",
"telephone_number": "612-872-9837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SROUFE",
"first_name": "JUNE",
"name_prefix": "Dr.",
"credential": "PH.D, L.P.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "2274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.