Paraclete Psychological Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LP5005 Issued in MN

Legal business name

PARACLETE PSYCHOLOGICAL SERVICES

Practice address

1030 County Road E W
Suite 260
Shoreview, MN 55126-8152

Phone

(715) 864-2417

Fax

(651) 528-8705

NPI assigned

Jun 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Marcus K Kilian, PSYD

Title

President/ Chief Manager

Phone

(715) 864-2417

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276473600000",
    "number": "1881915874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 COUNTY ROAD E W",
            "address_2": "SUITE 260",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268152",
            "telephone_number": "715-864-2417",
            "fax_number": "651-528-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 COUNTY ROAD E W",
            "address_2": "SUITE 260",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268152",
            "telephone_number": "715-864-2417",
            "fax_number": "651-528-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARACLETE PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A",
        "authorized_official_last_name": "KILIAN",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/ CHIEF MANAGER",
        "authorized_official_telephone_number": "715-864-2417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "LP5005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Shoreview, MN
• Providers in Shoreview, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; 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.