Individual provider Active NPI

Cynthia Ruth Pratt, M.A., L.P.

  • Psychologist
  • Saint Paul, MN
National Provider Identifier
1891835229
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
3495 Issued in MN
Practice address
821 Raymond Ave
Suite 300
Saint Paul, MN 55114-1503
Phone
(612) 721-6886
Fax
(612) 721-2832
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 3495 MN Primary

Addresses

Primary practice location

821 Raymond Ave
Suite 300
Saint Paul, MN 55114-1503

Mailing address

PO Box 6668
Minneapolis, MN 55406-0668
Phone (612) 721-6886

Other identifiers 1

IdentifierTypeStateIssuer
060T7NOOtherMNBLUE CROSS BLUE SHILD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3495MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891835229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6668",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554060668",
            "telephone_number": "612-721-6886",
            "fax_number": "612-721-2832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE",
            "address_2": "SUITE 300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141503",
            "telephone_number": "612-721-6886",
            "fax_number": "612-721-2832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRATT",
        "first_name": "CYNTHIA",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "M.A., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "3495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHILD",
            "identifier": "060T7NO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.