Individual provider Active NPI

Suzan S Hurlbut, LP

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1730284795
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2594 Issued in MN
Practice address
2550 University Ave W
Suite 435S
Saint Paul, MN 55114-1052
Phone
(651) 647-1900
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2594 MN Primary

Addresses

Primary practice location

2550 University Ave W
Suite 435S
Saint Paul, MN 55114-1052

Mailing address

2475 Sheldon St
Roseville, MN 55113-3138
Phone (651) 647-1900

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240510000874 MN Practitioner - Mental Health Counselor 3375994452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest Center for Personal and Family Development, P.a.Group PAC ID 3173436185, 17 clinicians

Practice addresses (Care Compare)

2550 University Ave W
Saint Paul, MN 55114-1052
Phone (651) 647-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2594MNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Center for Personal & Family Development PA CurrentSince Mar 31, 2024 Accepting new patients
Pathway Virtu-Health Past Accepting new patients

Locations

2550 University Ave W
Ste 435S
Saint Paul, MN 55114
Phone (651) 286-8527

2550 University Ave W
Saint Paul, MN 55114
Phone (651) 645-3115

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730284795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 SHELDON ST",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551133138",
            "telephone_number": "651-647-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 435S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-647-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HURLBUT",
        "first_name": "SUZAN",
        "middle_name": "S",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "2594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.