Psychology & Rehabilitation Services, LTD

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP2279 Issued in MN

Legal business name

PSYCHOLOGY & REHABILITATION SERVICES, LTD

Practice address

1535 Laurel Ave
Saint Paul, MN 55104-6739

Phone

(651) 645-0645

Fax

(651) 645-0630

NPI assigned

Jun 17, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Nathaniel Stewart Jr., M.A.,L.P., Q.R.C,CRCNPI 1225199052

Title

Ceo/Licensed Psychologist

Phone

(651) 645-0645

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 1

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

• Nathaniel Stewart Jr., M.A., L.P.

  • Group Psychotherapy Psychologist
  • Saint Paul, MN
  • NPI 1225199052
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245196800000",
    "number": "1740417757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LAUREL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046739",
            "telephone_number": "651-645-0645",
            "fax_number": "651-645-0630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LAUREL AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046739",
            "telephone_number": "651-645-0645",
            "fax_number": "651-645-0630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGY & REHABILITATION SERVICES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-17",
        "last_updated": "2009-06-17",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "NATHANIEL",
        "authorized_official_title_or_position": "CEO/LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-645-0645",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.A.,L.P., Q.R.C,CRC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP2279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "111770",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6273761",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "27815ST",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "86656ST",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA HEALTH CARE PROGRAMS",
            "identifier": "666348600",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychology of Health
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• Abigail Ann Psyck, MD
• Ptnow LLC
• Grace Paola Puchaicela Celi

• Community/Behavioral Health Agency in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2009; 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.