Individual provider Active NPI

Lisa J Torborg, PSY. D.

  • Counseling Psychologist
  • Waite Park, MN
National Provider Identifier
1669585253
Registry record updated Nov 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP4710 Issued in MN
Practice address
110 2ND St S
Suite 301
Waite Park, MN 56387-1314
Phone
(320) 252-2976
Fax
(320) 656-1570
NPI assigned
Aug 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X LP4710 MN Primary

Addresses

Primary practice location

110 2ND St S
Suite 301
Waite Park, MN 56387-1314

Mailing address

1740 W Saint Germain St
Suite 200
Saint Cloud, MN 56301-4059
Phone (320) 251-0223

Other identifiers 1

IdentifierTypeStateIssuer
797206700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061110000366 MN Practitioner - Clinical Psychologist 9436157203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Torborg and Kobienia Psychological Services LLCGroup PAC ID 9638498538, 2 clinicians

Practice addresses (Care Compare)

1740 W Saint Germain St
Suite 200
Saint Cloud, MN 56301-4059
Phone (320) 251-0223

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LP4710MNMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Torborg & Kobienia Psychological Services, LLC CurrentSince May 1, 2015 Accepting new patients

Locations

1740 W Saint Germain St
#200
Saint Cloud, MN 56301
Phone (320) 249-5207

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1669585253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1740 W SAINT GERMAIN ST",
            "address_2": "SUITE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563014059",
            "telephone_number": "320-251-0223",
            "fax_number": "320-251-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 2ND ST S",
            "address_2": "SUITE 301",
            "city": "WAITE PARK",
            "state": "MN",
            "postal_code": "563871314",
            "telephone_number": "320-252-2976",
            "fax_number": "320-656-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TORBORG",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-16",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP4710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "797206700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waite Park, MN

Sources for this page

Verify at the official NPI Registry.