Water Street Psychology

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP5063 Issued in MN

Legal business name

WATER STREET PSYCHOLOGY

Practice address

668 Meadow LN
Albert Lea, MN 56007-4301

Phone

(507) 377-1719

Fax

(507) 377-1724

NPI assigned

Sep 28, 2009

Organization subpart

No

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

Authorized official

Name

Beth Adair Olchefske, L.P.

Title

President

Phone

(507) 377-1719

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1254096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452038400000",
    "number": "1598099350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "668 MEADOW LN",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560074301",
            "telephone_number": "507-377-1719",
            "fax_number": "507-377-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "668 MEADOW LN",
            "city": "ALBERT LEA",
            "state": "MN",
            "postal_code": "560074301",
            "telephone_number": "507-377-1719",
            "fax_number": "507-377-1724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATER STREET PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-28",
        "last_updated": "2016-01-06",
        "status": "A",
        "authorized_official_last_name": "OLCHEFSKE",
        "authorized_official_first_name": "BETH",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-377-1719",
        "authorized_official_credential": "L.P."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP5063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Albert Lea, MN
• Providers in Albert Lea, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2016; 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.