Christos Napoleon Petsoulis, M.A., L.P.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP3014 Issued in MN

Practice address

314 W Superior St
Suite 600
Duluth, MN 55802-1805

Phone

(218) 727-7353

Fax

(218) 727-2646

NPI assigned

Mar 7, 2007

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 2

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

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

• The Institute for Psychological & Sexual Health, Inc.

  • Psychologist
  • Duluth, MN
  • NPI 1588794515
  NPD (past) Authorized official

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1588794598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W SUPERIOR ST",
            "address_2": "SUITE 600",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021805",
            "telephone_number": "218-727-7353",
            "fax_number": "218-727-2646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W SUPERIOR ST",
            "address_2": "SUITE 600",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558021805",
            "telephone_number": "218-727-7353",
            "fax_number": "218-727-2646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETSOULIS",
        "first_name": "CHRISTOS",
        "middle_name": "NAPOLEON",
        "credential": "M.A., L.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3014",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE MN",
            "identifier": "105522",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "30A54PE",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ross Leksell Peterson, CRNA
• Travis Reino Peterson
• Petoskey, Inc.
• Michael Petry, M.D.
• Sarah Utz Petry, M.D.
• Linda Petsoulis, M.A., L.P.
• Napoleon Petsoulis
• Haeli Anne Pettis
• Durae June Pfeffer
• Paige Elizabeth Pfeifer

• Psychologist in Duluth, MN
• Providers in Duluth, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.