Sally R Brinza PHD LP LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP2586 Issued in MN

Legal business name

SALLY R BRINZA PHD LP LLC

Practice address

7225 Forestview LN N
Maple Grove, MN 55369-5501

Phone

(612) 978-5058

NPI assigned

Mar 24, 2011

Organization subpart

No

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

Authorized official

Name

Sally Rose Brinza, PHD

Title

Psychologist

Phone

(612) 978-5058

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300924800000",
    "number": "1972802361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7225 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695501",
            "telephone_number": "612-978-5058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7225 FORESTVIEW LN N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553695501",
            "telephone_number": "612-978-5058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY R BRINZA PHD LP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A",
        "authorized_official_last_name": "BRINZA",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "ROSE",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-978-5058",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP2586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA HEALTH CARE PROGRAM MA",
            "identifier": "7140533-00",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MINNESOTA CARE",
            "identifier": "6420206",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Maple Grove, MN
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• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2011; 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.