Jeanette Mildred Balfe-Groh, PSY.D

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

6860 Shingle Creek Pkwy
Suite 116
Brooklyn Center, MN 55430-1411

Phone

(763) 560-4860

Fax

(763) 503-1430

NPI assigned

Jan 11, 2008

Last updated

Jan 11, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Group practices

Shoreview Mental Health Center LLCGroup PAC ID 6204121338, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Shoreview Mental Health Center, LLC

  • Psychologist
  • Shoreview, MN
  • NPI 1558735779
  Medicare reassignment Care Compare group NPD Authorized official
• The Counseling Clinic, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brooklyn Center, MN
  • NPI 1750300620
  NPD (past)

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

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1730365511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6860 SHINGLE CREEK PARKWAY",
            "address_2": "SUITE 116",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "55430",
            "telephone_number": "763-560-4860",
            "fax_number": "763-503-1430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6860 SHINGLE CREEK PKWY",
            "address_2": "SUITE 116",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554301411",
            "telephone_number": "763-560-4860",
            "fax_number": "763-503-1430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALFE-GROH",
        "first_name": "JEANETTE",
        "middle_name": "MILDRED",
        "credential": "PSY.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-11",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Badger Acquisition of Minnesota, LLC (Omnicare of Minnesota)
• Lakeisha Shuntay Bady
• Christopher Paul Baecker, CNA
• Claude Thomas Baker, PA
• Bruce Lee Bakke, PH.D.
• Balm of Gilead Health Services LLC
• Maggie Elizabeth Bania, LP
• Elizabeth Steele Banovetz, LMFT
• Muringo Barasa
• Kiara Barlow

• Psychologist in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2008; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.