NPIMap

Organization Active NPI

HP Psychological Associates, PC

  • Community/Behavioral Health Agency
  • Duluth, MN
National Provider Identifier
1780132696
Registry record updated Nov 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
221 Issued in MN
Legal business name
HP PSYCHOLOGICAL ASSOCIATES, PC
Practice address
4815 Burning Tree Rd
Duluth, MN 55811-3800
Phone
(218) 390-7193
Fax
(218) 628-1734
NPI assigned
Sep 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2017

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

Authorized official

Name
Kimberly Overlie, LPCCNPI 1730365826
Title
Ceo
Phone
(218) 390-7193

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 221 MN Primary

Addresses

Primary practice location

4815 Burning Tree Rd
Duluth, MN 55811-3800

Mailing address

PO Box 1066
Proctor, MN 55810-0066
Phone (218) 390-7193

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180719000356 MN Part B Supplier - Clinic/Group Practice 1951658152 Receives reassigned benefits from 10 practitioners
Practice locations: Hermantown, MN

National Provider Directory

National Provider Directory

Locations

4815 Burning Tree Rd
Ste 200
Duluth, MN 55811
Phone (218) 464-0908

4815 Burning Tree Rd
Duluth, MN 55811
Phone (218) 390-7193

4135 Richard Ave
Ste 201
Hermantown, MN 55811
Phone (218) 464-0908

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510272000000",
    "number": "1780132696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1066",
            "city": "PROCTOR",
            "state": "MN",
            "postal_code": "558100066",
            "telephone_number": "218-390-7193",
            "fax_number": "218-628-1734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4815 BURNING TREE RD",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113800",
            "telephone_number": "218-390-7193",
            "fax_number": "218-628-1734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HP PSYCHOLOGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-20",
        "last_updated": "2017-11-10",
        "status": "A",
        "authorized_official_last_name": "OVERLIE",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "218-390-7193",
        "authorized_official_credential": "LPCC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2017; 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.