Individual provider Active NPI

Deborah Rich, PH.D., LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1710101290
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1281 Issued in MN
Practice address
1619 Dayton Ave Ste 201
Saint Paul, MN 55104
Phone
(651) 645-5504
Fax
(651) 404-2512
NPI assigned
Apr 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 1281 MN Primary

Addresses

Primary practice location

1619 Dayton Ave Ste 201
Saint Paul, MN 55104

Mailing address

1619 Dayton Ave Ste 201
Saint Paul, MN 55104-6276
Phone (651) 645-5504

Other practice location 1

570 Asbury St
#310
Saint Paul, MN 55104-1849
Phone (651) 659-9971

Other identifiers 2

IdentifierTypeStateIssuer
18G09RIOtherMNBLUE CROSS BS PIN NUMBER
18G08RIOtherMNBLUE CROSS BS GROUP NUMBE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1281MNMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1710101290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046276",
            "telephone_number": "651-645-5504",
            "fax_number": "651-404-2512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 DAYTON AVE STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "55104",
            "telephone_number": "651-645-5504",
            "fax_number": "651-404-2512"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "570 Asbury St",
            "address_2": "#310",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551041849",
            "country_code": "US",
            "telephone_number": "651-659-9971",
            "fax_number": "651-603-8528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RICH",
        "first_name": "DEBORAH",
        "name_prefix": "Dr.",
        "credential": "PH.D., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "1281",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS  BS PIN NUMBER",
            "identifier": "18G09RI",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BS GROUP NUMBE",
            "identifier": "18G08RI",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.