Clinical and Forensic Psychology LTD

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP1768 Issued in MN

Legal business name

CLINICAL AND FORENSIC PSYCHOLOGY LTD

Practice address

2677 Innsbruck Dr
Suite D
Saint Paul, MN 55112-6395

Phone

(612) 581-6655

Fax

(651) 633-9485

NPI assigned

Mar 25, 2009

Last updated

Mar 25, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Harlan Gilbertson, PHD

Title

President

Phone

(612) 581-6655

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237939200000",
    "number": "1669614483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POST OFFICE BOX 67",
            "city": "BARNUM",
            "state": "MN",
            "postal_code": "55707",
            "telephone_number": "612-581-6655",
            "fax_number": "651-633-9485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2677 INNSBRUCK DR",
            "address_2": "SUITE D",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551126395",
            "telephone_number": "612-581-6655",
            "fax_number": "651-633-9485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL AND FORENSIC PSYCHOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A",
        "authorized_official_last_name": "GILBERTSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "HARLAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-581-6655",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP1768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420247300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Saint Paul, MN
• Providers in Saint Paul, 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 Mar 25, 2009; 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.