Developmental Impact LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

2474 Issued in MN

Legal business name

DEVELOPMENTAL IMPACT LLC

Practice address

720 8TH Ave N
Saint Cloud, MN 56303-3420

Phone

(320) 420-2234

Fax

(320) 251-0217

NPI assigned

Jun 6, 2017

Last updated

Jul 21, 2022By 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

Theresa Schreifels, LMFTNPI 1720327364

Title

Ceo

Phone

(320) 420-2234

Specialties & licenses 3

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Theresa J Schreifels, LMFT

  • Marriage & Family Therapist
  • Saint Cloud, MN
  • NPI 1720327364
  Authorized official Same address or phone

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1669901393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 8TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563033420",
            "telephone_number": "320-420-2234",
            "fax_number": "320-251-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 8TH AVE N",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563033420",
            "telephone_number": "320-420-2234",
            "fax_number": "320-251-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL IMPACT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-06",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHREIFELS",
        "authorized_official_first_name": "THERESA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "320-420-2234",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MN",
            "license": "2474",
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "MN",
            "license": "2474",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "MN",
            "license": "2474",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720327364",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kylie Danielle Deschane
• Anne Elizabeth Deters, RN
• Anne Elizabeth Deters, LPCC
• Jenifer Karen Detert, P.A.
• Sindhu M. Devani, MD
• Sara Devos
• Sara Dezell, R.N.
• Gati Niranjan Dhroove, MBBS
• Heather Diaz, PHARMD
• Allison Marie Diederich

• Mental Health Clinic/Center (Including Community Mental Health Center) in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.