Somers Psychological Services, LLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

SOMERS PSYCHOLOGICAL SERVICES, LLC

Practice address

16 N Shore Dr
Winnebago, MN 56098-3345

Phone

(612) 396-1699

Fax

(507) 893-3031

NPI assigned

Jun 10, 2019

Last updated

Jun 10, 2019By 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

Peter Somers, PH.D.

Title

Ceo

Phone

(612) 396-1699

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1560124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560124800000",
    "number": "1861051351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N SHORE DR",
            "city": "WINNEBAGO",
            "state": "MN",
            "postal_code": "560983345",
            "telephone_number": "612-396-1699",
            "fax_number": "507-893-3031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N SHORE DR",
            "city": "WINNEBAGO",
            "state": "MN",
            "postal_code": "560983345",
            "telephone_number": "612-396-1699",
            "fax_number": "507-893-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERS PSYCHOLOGICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-10",
        "last_updated": "2019-06-10",
        "status": "A",
        "authorized_official_last_name": "SOMERS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "612-396-1699",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.