Iris Song, PSY.D., L.P.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP5547 Issued in MN

Practice address

7979 Ranchview LN N
Maple Grove, MN 55311-2106

Phone

(612) 203-8027

NPI assigned

Oct 23, 2014

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Uw Counseling Center

  • Mental Health Counselor
  • Seattle, WA
  • NPI 1801467659
  NPD (past)

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414022400000",
    "number": "1790180503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7979 RANCHVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7979 RANCHVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553112106",
            "telephone_number": "612-203-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "IRIS",
        "credential": "PSY.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2014-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP5547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Solace Health Services LLC
• Carolyn S. Solberg, PNP
• Jeremiah Solveson, RN
• Sabreena Solway, MA, LMFT
• Somers Psychological Services, P.a.
• Sota Therapy
• Soul Savvy Counseling and Therapy Services LLC
• Sound Sleep Centers
• Sound ZZZ Medical Equipment
• South Lake Clinic, PA

• Clinical Psychologist in Maple Grove, MN
• Providers in Maple Grove, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2014; 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.