Primary Behavioral Health Clinic, Inc.

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PRIMARY BEHAVIORAL HEALTH CLINIC, INC.

Practice address

3433 Broadway St NE Ste 160
Minneapolis, MN 55413-1756

Phone

(612) 378-2363

Fax

(612) 378-2215

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Carole Sax

Title

Manager

Phone

(612) 378-2363

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209945600000",
    "number": "1639254840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 160",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131756",
            "telephone_number": "612-378-2363",
            "fax_number": "612-378-2215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3433 BROADWAY ST NE STE 160",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131756",
            "telephone_number": "612-378-2363",
            "fax_number": "612-378-2215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY BEHAVIORAL HEALTH CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-05-05",
        "status": "A",
        "authorized_official_last_name": "SAX",
        "authorized_official_first_name": "CAROLE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "612-378-2363"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2008; 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.