NPIMap

Organization Active NPI

Tazelaar Psychotherapy Services LLC

  • Clinical Social Worker
  • Saint Paul, MN
National Provider Identifier
1811286594
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
9454 Issued in MN
Legal business name
TAZELAAR PSYCHOTHERAPY SERVICES LLC
Practice address
1595 Selby Ave
Saint Paul, MN 55104-6221
Phone
(651) 699-6480
Fax
(651) 699-4889
NPI assigned
Apr 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Authorized official

Name
Ms. Sandra Lee Tazelaar, LICSWNPI 1982648341
Title
Owner
Phone
(651) 699-6480

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 9454 MN Primary

Addresses

Primary practice location

1595 Selby Ave
Saint Paul, MN 55104-6221

Mailing address

232 Snelling Ave S
Saint Paul, MN 55105-1944
Phone (651) 699-6480

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427241600000",
    "number": "1811286594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "232 SNELLING AVE S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551051944",
            "telephone_number": "651-699-6480",
            "fax_number": "651-699-4889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1595 SELBY AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551046221",
            "telephone_number": "651-699-6480",
            "fax_number": "651-699-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAZELAAR PSYCHOTHERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-01",
        "last_updated": "2015-03-25",
        "status": "A",
        "authorized_official_last_name": "TAZELAAR",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-699-6480",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "9454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.