Rachelle Lillian Lisogurski, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP2596 Issued in MN

Practice address

4432 Chicago Ave
Chrysalis
Minneapolis, MN 55407-3519

Phone

(612) 871-0118

NPI assigned

Aug 12, 2007

Last updated

Aug 23, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  MN

  Medicare reassignment
• 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": "1186876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1689866808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10411 CEDAR LAKE RD",
            "address_2": "APT 319",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553053288",
            "telephone_number": "612-871-0118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4432 CHICAGO AVE",
            "address_2": "CHRYSALIS",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073519",
            "telephone_number": "612-871-0118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISOGURSKI",
        "first_name": "RACHELLE",
        "middle_name": "LILLIAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-12",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin L Lipschultz, M.D.
• Sharon D. Lipscomb, F.N.P.
• Lisa Cryns Therapy
• Steve Lish
• Deborah Kay Lisko, RD
• Jennifer Rae Lissick
• Andrea List, OT
• Anne L List
• Julia Lister, M.D.
• Alan M. Listiak

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.