St. Cloud Neurobehavioral Associates PA

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

ST. CLOUD NEUROBEHAVIORAL ASSOCIATES PA

Practice address

3812 8TH St N Ste 200
Saint Cloud, MN 56303-1413

Phone

(320) 258-3833

Fax

(320) 253-5741

NPI assigned

Apr 6, 2006

Organization subpart

No

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

Authorized official

Name

Jessica Ward

Title

Office Manager

Phone

(320) 258-3833

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 4

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

• Jeffrey Kearney, PHD, LP

  • Clinical Neuropsychologist
  • Saint Cloud, MN
  • NPI 1962469171
  Medicare reassignment Care Compare group NPD
• Timothy Ryan Rysavy, PSYD, LP

  • Psychologist
  • St. Cloud, MN
  • NPI 1073052163
  Medicare reassignment Care Compare group NPD
• Jessica Louise Lee, PSYD, LP

  • Clinical Psychologist
  • St. Cloud, MN
  • NPI 1982249009
  Medicare reassignment NPD
• Andrine Marie Lemieux, PH.D., L.P.

  • Clinical Neuropsychologist
  • Duluth, MN
  • NPI 1750537874
  NPD (past)

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1871555441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 8TH ST N STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031413",
            "telephone_number": "320-258-3833",
            "fax_number": "320-253-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3812 8TH ST N STE 200",
            "city": "SAINT CLOUD",
            "state": "MN",
            "postal_code": "563031413",
            "telephone_number": "320-258-3833",
            "fax_number": "320-253-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLOUD NEUROBEHAVIORAL ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-06",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "320-258-3833"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Hospital
• St. Cloud Metropolitan Transit Commission
• St. Cloud Neurobehavioral Associates, PA
• St. Cloud Outpatient Surgery, LTD.
• St. Cloud Podiatry Clinic, P.a.
• St. Cloud Rehab LLC
• St. Cloud Silver Lining, Inc

• Medical Specialty Clinic/Center in Saint Cloud, MN
• Providers in Saint Cloud, MN by specialty
• Medical Specialty Clinic/Center in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.