West Metro Education Program

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

475-878 Issued in MN

Legal business name

WEST METRO EDUCATION PROGRAM

Practice address

10 S 10TH St
Minneapolis, MN 55403-2033

Phone

(612) 752-7100

NPI assigned

Nov 7, 2013

Last updated

Nov 7, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Dave Haveman

Title

Director of Special Education

Phone

(651) 431-0680

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383782400000",
    "number": "1962831131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 S 10TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032033",
            "telephone_number": "612-752-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S 10TH ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554032033",
            "telephone_number": "612-752-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST METRO EDUCATION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A",
        "authorized_official_last_name": "HAVEMAN",
        "authorized_official_first_name": "DAVE",
        "authorized_official_title_or_position": "DIRECTOR OF SPECIAL EDUCATION",
        "authorized_official_telephone_number": "651-431-0680",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, School",
            "state": "MN",
            "license": "475-878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• School Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2013; 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.