NPIMap

Organization Active NPI

Susan Borden Psych

  • Psychiatric/Mental Health Nurse Practitioner
  • Saint Paul, MN
National Provider Identifier
1780313478
Registry record updated May 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SUSAN BORDEN PSYCH
Practice address
2303 Wycliff St Ste W210
Saint Paul, MN 55114-1272
Phone
(612) 424-0434
Fax
(877) 905-7069
NPI assigned
Jun 8, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2026

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

Authorized official

Name
Susan Borden, PMHNPNPI 1427692060
Title
Owner
Phone
(612) 424-0434

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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X
NutritionistGroup: 193200000X MULTI-SPECIALTY GROUP 133N00000X
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

2303 Wycliff St Ste W210
Saint Paul, MN 55114-1272

Mailing address

104 Seymour Ave SE
Minneapolis, MN 55414-3558
Phone (612) 424-0434

Other names 1

  • Center for Conscious Alchemy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240326001340 MN Part B Supplier - Clinic/Group Practice 4688011612 Receives reassigned benefits from 15 practitioners
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Locations

2303 Wycliff St
Ste W210
Saint Paul, MN 55114
Phone (612) 424-0434

2303 Wycliff St
Ste 210
Saint Paul, MN 55114
Phone (612) 424-0434

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1654646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779148800000",
    "number": "1780313478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SEYMOUR AVE SE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554143558",
            "telephone_number": "612-424-0434",
            "fax_number": "877-905-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2303 WYCLIFF ST STE W210",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141272",
            "telephone_number": "612-424-0434",
            "fax_number": "877-905-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN BORDEN PSYCH",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-08",
        "last_updated": "2026-05-19",
        "certification_date": "2026-05-19",
        "status": "A",
        "authorized_official_last_name": "BORDEN",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-424-0434",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Center for Conscious Alchemy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Center for Conscious Alchemy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2026; 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.