Active NPI
Cynthia J. Haakana, LLC
- Clinical Psychologist
- St Louis Park, MN
National Provider Identifier
1679968341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP1056
- Legal business name
- CYNTHIA J. HAAKANA, LLC
- Practice address
- 4500 Park Glen Rd Ste 155
St Louis Park, MN 55416-4888 - Phone
- (952) 928-0618
- NPI assigned
- Mar 31, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Cynthia Jane Haakana, PH.D.
- Title
- Owner
- Phone
- (952) 928-0618
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP1056 | MN | Primary |
Addresses
Primary practice location
4500 Park Glen Rd Ste 155
St Louis Park, MN 55416-4888
Mailing address
4500 Park Glen Rd Ste 155
St Louis Park, MN 55416-4888
Phone (952) 928-0618
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 393050500 | Medicaid | MN |
Other names 1
- Cynthia J. Haakana, Ph.D., L.P.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427760000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1427760000000",
"number": "1679968341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 PARK GLEN RD STE 155",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554164888",
"telephone_number": "952-928-0618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 PARK GLEN RD STE 155",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554164888",
"telephone_number": "952-928-0618"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CYNTHIA J. HAAKANA, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-03-31",
"last_updated": "2015-03-31",
"status": "A",
"authorized_official_last_name": "HAAKANA",
"authorized_official_first_name": "CYNTHIA",
"authorized_official_middle_name": "JANE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "952-928-0618",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PH.D."
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1056",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "393050500",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Cynthia J. Haakana, Ph.D., L.P.",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.