Active NPI
Phyllis Mary Kulhanek
- Clinical Psychologist
- Eagan, MN
National Provider Identifier
1922196344
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP3731
- Practice address
- 1803 E Bluestone Dr
Eagan, MN 55122-2952 - Phone
- (651) 452-3200
- NPI assigned
- Oct 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP3731 | MN | Primary |
Addresses
Primary practice location
1803 E Bluestone Dr
Eagan, MN 55122-2952
Mailing address
1803 E Bluestone Dr
Eagan, MN 55122-2952
Phone (651) 452-3200
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3731 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hudson Counseling Clinic, LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Burnsville, MN
- NPI 1174972558
Clinical
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922196344",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1803 E BLUESTONE DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551222952",
"telephone_number": "651-452-3200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1803 E BLUESTONE DR",
"city": "EAGAN",
"state": "MN",
"postal_code": "551222952",
"telephone_number": "651-452-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KULHANEK",
"first_name": "PHYLLIS",
"middle_name": "MARY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP3731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eagan, 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.