Southern Minnesota Psychological Services, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOUTHERN MINNESOTA PSYCHOLOGICAL SERVICES, PLLC

Practice address

329 N Main St Ste 104L
Austin, MN 55912-3478

Phone

(507) 434-1092

NPI assigned

Aug 26, 2019

Organization subpart

No

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

Authorized official

Name

Timothy Patrick LangNPI 1205813037

Title

Clinical Psychologist

Phone

(507) 434-1092

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy Patrick Lang, PSY.D.,LP

  • Clinical Psychologist
  • Austin, MN
  • NPI 1205813037
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689724800000",
    "number": "1720635519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 9TH AVE SW",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559125406",
            "telephone_number": "507-438-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 N MAIN ST STE 104L",
            "city": "AUSTIN",
            "state": "MN",
            "postal_code": "559123478",
            "telephone_number": "507-434-1092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MINNESOTA PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "507-434-1092"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.