Active NPI
Jane A Coffey, PSY.D.
- Clinical Psychologist
- Roseville, MN
National Provider Identifier
1780728782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP4230
- Practice address
- 1700 Highway 36 W
516 Rosedale Towers
Roseville, MN 55113-4034 - Phone
- (651) 631-1090
- Fax
- (612) 926-7178
- NPI assigned
- Feb 16, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP4230 | MN | Primary |
Addresses
Primary practice location
1700 Highway 36 W
516 Rosedale Towers
Roseville, MN 55113-4034
Mailing address
4700 W 29TH St
St Louis Park, MN 55416-1977
Phone (952) 926-6514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP4230 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1780728782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4700 W 29TH ST",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "554161977",
"telephone_number": "952-926-6514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 HIGHWAY 36 W",
"address_2": "516 ROSEDALE TOWERS",
"city": "ROSEVILLE",
"state": "MN",
"postal_code": "551134034",
"telephone_number": "651-631-1090",
"fax_number": "612-926-7178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COFFEY",
"first_name": "JANE",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4230",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roseville, MN
- Melanie R Cleveland, LPCC
- Suzanne Clifton
- Bradley Close, M.D.
- John A Coburn, M.D.
- Meghann Rae Cody, DNP, APRN, CNP
- Deirdre Coleman, CMT
- Madeline Terese Collins, APRN, CPNP-PC
- Community Drug & Alcohol Services Inc (Options Family & Behavior Services)
- Community Drug& Alcohol Services Inc (OPTIONS Family & Behavior Services)
- Community Medical Services Montana-Private, LLC (Community Medical Services)
Sources for this page
- 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.