Great Lakes Psychological Services, PC

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

GREAT LAKES PSYCHOLOGICAL SERVICES, PC

Practice address

3101 Superior Dr NW
Rochester, MN 55901-1993

Phone

(507) 288-8544

NPI assigned

Jan 5, 2021

Last updated

Jan 5, 2021By 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

Mr. Seth Franz

Title

President

Phone

(507) 288-8544

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1609804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609804800000",
    "number": "1821686957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 SUPERIOR DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3101 SUPERIOR DR NW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559011993",
            "telephone_number": "507-288-8544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4325 W Woodman St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Pequot Lakes",
            "state": "MN",
            "postal_code": "564723473",
            "country_code": "US",
            "telephone_number": "218-568-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12805 Highway 55",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554413859",
            "country_code": "US",
            "telephone_number": "763-550-9005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "422 Heritage Pl",
            "address_purpose": "LOCATION",
            "city": "Faribault",
            "state": "MN",
            "postal_code": "550215248",
            "country_code": "US",
            "telephone_number": "507-333-5044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREAT LAKES PSYCHOLOGICAL SERVICES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-05",
        "last_updated": "2021-01-05",
        "certification_date": "2021-01-05",
        "status": "A",
        "authorized_official_last_name": "FRANZ",
        "authorized_official_first_name": "SETH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-288-8544",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Jay Gray, D.D.S., M.S.
• Henry Gray
• Leacia Gray
• Leah Olson Grcevich, DO
• Kevin L. Greason, M.D.
• Stefan K Grebe, M.D.
• Ashley Evelyn Green, MD
• Azana Kacie Green, SLP
• Emma Green
• Isabel C Green, M.D.

• Psychologist in Rochester, MN
• Providers in Rochester, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2021; 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.