Janet Stam Psy,D, PA

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4793 Issued in MN

Legal business name

JANET STAM PSY,D, PA

Practice address

950 County Road 10
Suite 109
Spring Lake Park, MN 55432-1253

Phone

(763) 754-2917

Fax

(763) 717-3088

NPI assigned

Nov 13, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Janet Carol Stam

Title

Sole Proprietor

Phone

(763) 754-2917

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1289606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289606400000",
    "number": "1992006548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 COUNTY ROAD 10",
            "address_2": "SUITE 109",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554321253",
            "telephone_number": "763-754-2917",
            "fax_number": "763-717-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 COUNTY ROAD 10",
            "address_2": "SUITE 109",
            "city": "SPRING LAKE PARK",
            "state": "MN",
            "postal_code": "554321253",
            "telephone_number": "763-754-2917",
            "fax_number": "763-717-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JANET STAM PSY,D, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-13",
        "last_updated": "2010-11-13",
        "status": "A",
        "authorized_official_last_name": "STAM",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "CAROL",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "763-754-2917",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Spring Lake Park, MN
• Providers in Spring Lake Park, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2010; 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.