Veemah Integrated Wellness & Consulting Services, LLC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP6152 Issued in MN

Legal business name

VEEMAH INTEGRATED WELLNESS & CONSULTING SERVICES, LLC

Practice address

11112 Hillsboro Ave N
Champlin, MN 55316-3128

Phone

(763) 228-8086

NPI assigned

Feb 8, 2018

Last updated

Feb 8, 2018By 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

Dr. Vivian Korpo Ballah-Swaray, PSYD, LPNPI 1902316821

Title

Psychologist

Phone

(763) 228-8086

Specialties & licenses 1

Addresses

Other names 1

• VEEMAH Integrated Wellness & Consulting Services, LLC Former legal business name

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Vivian Ballah-Swaray, PSYD

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1902316821
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1518048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1982103644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11112 HILLSBORO AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11112 HILLSBORO AVE N",
            "city": "CHAMPLIN",
            "state": "MN",
            "postal_code": "553163128",
            "telephone_number": "763-228-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VEEMAH INTEGRATED WELLNESS & CONSULTING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-08",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "BALLAH-SWARAY",
        "authorized_official_first_name": "VIVIAN",
        "authorized_official_middle_name": "KORPO",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "763-228-8086",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP6152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VEEMAH Integrated Wellness & Consulting Services, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Psychologist in Champlin, MN
• Providers in Champlin, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.