Celeste Rose Yanisch, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP3761 Issued in MN

Practice address

3570 Lexington Ave N
Suite 100
Shoreview, MN 55126-8049

Phone

(651) 481-0664

NPI assigned

Mar 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bohn Counseling Associates, Inc,

  • Clinical Psychologist
  • Mahtomedi, MN
  • NPI 1881876050
  NPD (past)
• Outreach Counseling & Consulting Services, Inc.

  • Professional Counselor
  • Shoreview, MN
  • NPI 1295890192

  Clinical

  NPD (past)
• Supportive Journeys Psychotherapy, LLC

  • Clinical Social Worker
  • St. Paul, MN
  • NPI 1629404074
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780715417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 UPPER AFTON RD",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551066839",
            "telephone_number": "651-772-2577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 LEXINGTON AVE N",
            "address_2": "SUITE 100",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268049",
            "telephone_number": "651-481-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YANISCH",
        "first_name": "CELESTE",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP3761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "79G96YA",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL ASSISTANCE NUMBER",
            "identifier": "941419300",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS NUMBER",
            "identifier": "HP46412",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Woodcrest Counseling, Inc
• Jacob Woolley
• Jeff Worley, LICSW
• Janet Xiong
• Emily Yang, PHARMD
• Douglas Yost, D.C.
• Miriam Zachary, MA, LMFT
• Diane Marie Zimmerman, DDS
• Olivia Zoner, OT, D
• Zubeer Group Home LLC

• Clinical Psychologist in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.