Michael R Hamberg, PSY.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

4955 Issued in MN

Practice address

1 Mendota Rd W
West St Paul, MN 55118-4764

Phone

(651) 554-6310

Fax

(651) 554-6043

NPI assigned

Oct 16, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Associated Clinic of Psychology Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Louis Park, MN
  • NPI 1588741292
  NPD (past)

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1639321094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MENDOTA RD W",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551184764",
            "telephone_number": "651-554-6310",
            "fax_number": "651-554-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MENDOTA RD W",
            "city": "WEST ST PAUL",
            "state": "MN",
            "postal_code": "551184764",
            "telephone_number": "651-554-6310",
            "fax_number": "651-554-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMBERG",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "4955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Brice Gonzalez-Couture, PT, DPT
• Goshen Concept Care LLC
• Madison Gratzer, DPT
• Marcela A Guerra
• Katherine Louise Hall, PT
• John Travis Hansen, PHARMD
• Ashley Hanson-Oni
• Lindsay Harmon
• Nicole Michelle Helland, LICSW
• Elizabeth Ann Hendrikson, LICSW

• Counseling Psychologist in West St Paul, MN
• Providers in West St Paul, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.