Richelle Moen, PHD LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP2440 Issued in MN

Legal business name

RICHELLE MOEN, PHD LLC

Practice address

4826 Chicago Ave Ste 207
Minneapolis, MN 55417-1063

Phone

(612) 743-7788

Fax

(612) 824-7341

NPI assigned

Feb 14, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Richelle Naomi Moen, PHD

Title

Owner

Phone

(612) 743-7788

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1329177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329177600000",
    "number": "1801169347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4826 CHICAGO AVE STE 207",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4826 CHICAGO AVE STE 207",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171063",
            "telephone_number": "612-743-7788",
            "fax_number": "612-824-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHELLE MOEN, PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-14",
        "last_updated": "2012-02-14",
        "status": "A",
        "authorized_official_last_name": "MOEN",
        "authorized_official_first_name": "RICHELLE",
        "authorized_official_middle_name": "NAOMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-743-7788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP2440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M. Reuben Richardson, CRNA
• Melissa Richardson, PA-C
• Portia Richardson, L.AC.
• Ryan Richardson, MD
• Stephen Richardson, M.D.
• Lucas Daniel Richer, OTD
• Brittany Rose Richert, MSW, LICSW
• Pamela P Richey, LICSW
• Naomi R Richman, L.AC.
• Steven Richmond, DO

• Community/Behavioral Health Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; 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.