Kate Theisz, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4647 Issued in MN

Practice address

657 Main St NW Ste 214
Elk River, MN 55330-1579

Phone

(763) 412-1994

Fax

(763) 412-1994

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Aurora Healing Inc

  • Clinical Psychologist
  • Elk River, MN
  • NPI 1376007708
  NPD (past)

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1861567513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20934 OGDEN ST NW",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553308909",
            "telephone_number": "612-242-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 MAIN ST NW STE 214",
            "city": "ELK RIVER",
            "state": "MN",
            "postal_code": "553301579",
            "telephone_number": "763-412-1994",
            "fax_number": "763-412-1994"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2330 Sioux Trl NW",
            "address_purpose": "LOCATION",
            "city": "Prior Lake",
            "state": "MN",
            "postal_code": "553729077",
            "country_code": "US",
            "telephone_number": "952-496-6164",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26219 Fremont Dr Ste C",
            "address_purpose": "LOCATION",
            "city": "Zimmerman",
            "state": "MN",
            "postal_code": "553984550",
            "country_code": "US",
            "telephone_number": "763-412-1994",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THEISZ",
        "first_name": "KATE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4647",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP4647",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Ann Teal
• Leah Temple
• Cassandra Marie Terch
• The Creative Therapy Center, LLC
• Garrett Connor Theiringer
• Sujaya Thogaru
• Darin William Thom, PT
• Erick Thompson, DC
• Kylee Lynn Thompson
• Linda Kaye Thompson, LP

• Clinical Psychologist in Elk River, MN
• Providers in Elk River, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.