Psychological&Behavioralconsultantspa

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

PSYCHOLOGICAL&BEHAVIORALCONSULTANTSPA

Practice address

2186 3Rd St
Suite 105
White Bear Lake, MN 55110-3263

Phone

(651) 227-8880

Fax

(651) 227-8908

NPI assigned

Mar 4, 2007

Last updated

Feb 24, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. W S Balcerzak, PH.D.

Title

Ceo

Phone

(651) 227-8880

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ritamarie Risley Balcerzak, M.A.

  • Psychologist
  • White Bear Lake, MN
  • NPI 1104955418
  NPD (past)

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

{
    "created_epoch": "1172966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361664000000",
    "number": "1811026123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2186 3RD ST",
            "address_2": "SUITE 105",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103263",
            "telephone_number": "651-227-8880",
            "fax_number": "651-227-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2186 3RD ST",
            "address_2": "SUITE 105",
            "city": "WHITE BEAR LAKE",
            "state": "MN",
            "postal_code": "551103263",
            "telephone_number": "651-227-8880",
            "fax_number": "651-227-8908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHOLOGICAL&BEHAVIORALCONSULTANTSPA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-04",
        "last_updated": "2013-02-24",
        "status": "A",
        "authorized_official_last_name": "BALCERZAK",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "651-227-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in White Bear Lake, MN
• Providers in White Bear Lake, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2013; 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.