Suburban North Psychological Services, P.a.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP 2514 Issued in MN

Legal business name

SUBURBAN NORTH PSYCHOLOGICAL SERVICES, P.A.

Practice address

1313 5TH St SE
Mailbox 45, Suite 114 B
Minneapolis, MN 55414-4504

Phone

(612) 819-7485

Fax

(612) 379-3183

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ferde William Fritsche, PH.D., L.P.

Title

Licensed Psychologist

Phone

(651) 647-1653

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Dennis M. Brekke, PH.D.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1508962960
  NPD

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972727105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 CALIFORNIA AVE W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551082105",
            "telephone_number": "651-647-1653",
            "fax_number": "612-379-3183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 5TH ST SE",
            "address_2": "MAILBOX 45, SUITE 114 B",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554144504",
            "telephone_number": "612-819-7485",
            "fax_number": "612-379-3183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN NORTH PSYCHOLOGICAL SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FRITSCHE",
        "authorized_official_first_name": "FERDE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "651-647-1653",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., L.P."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP 2514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anay Suarez
• Holly Lynn Suarez, DC
• Laurie Ann Sublett, NP
• Submerge in Sensory
• Krishnan Namboodiri Subrahmanian, MD
• Success in Motion Therapy LLC
• Maria Succio
• James Paul Suchy, MPT
• Jennifer Lynn Ische Suchy, CNNP
• Elianna Suddard-Bangsund, OTD, OTR/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.