SBTV LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

SBTV LLC

Practice address

6121 Excelsior Blvd Ste 101a
St Louis Park, MN 55416-2752

Phone

(612) 440-8742

Fax

(716) 531-9060

NPI assigned

Mar 20, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Natalie M Marr, PSY.D., LP

Title

Owner

Phone

(612) 440-8742

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SBTV LLC Doing business as

Locations

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

{
    "created_epoch": "1553040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1992265615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490171",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554490171",
            "telephone_number": "612-440-8742",
            "fax_number": "716-531-9060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6121 EXCELSIOR BLVD STE 101A",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162752",
            "telephone_number": "612-440-8742",
            "fax_number": "716-531-9060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SBTV LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-20",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "MARR",
        "authorized_official_first_name": "NATALIE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "612-440-8742",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D., LP"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4960",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SBTV LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amy L Sauter, RD
• Neil J Sauter, DPT
• Jebediah Joel Sawyer, MA
• Martha Kristin Sawyer, OTR/L
• Kharmen Saysirisanh
• Kelly Ann Yaeger Scalzo
• Erin Marie Scanlon
• Natalie Scanlon
• Thomas M Scaramuzza, OD
• Richard J Scarlato, PT

• Mental Health Clinic/Center (Including Community Mental Health Center) in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.