DR. SHANNON THOMAS WOULFE (NPI# 1225593825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1225593825 |
Entity Type | Individual |
Full Name | DR. SHANNON THOMAS WOULFE |
Credential | PH.D., LP |
Practice Address |
550 Osborne Rd Ne Fridley MN 55432-2718 |
Mailing Address |
2954 Cherry Hill Ln Little Canada MN 55109-1218 |
Practice Telephone | 7632365000 |
Mailing Telephone | 6512358459 |
Enumeration Date | 2019-02-07 |
Last Update Date | 2019-02-07 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TC0700X |
Psychologist Specialization: Clinical |
4673 | MN | Behavioral Health & Social Service Providers |
Street Address |
550 OSBORNE RD NE |
City | FRIDLEY |
State | MN |
Zip Code | 55432-2718 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689666497 | Jeffrey S Herman | Radiology | 550 Osborne Rd Ne, Unity Radiation Therapy Ctr, Fridley, MN 55432-2718 | 2005-08-17 |
1982231189 | Sylvia Lirazan | Physical Medicine & Rehabilitation | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2020-03-26 |
1487206926 | Marie Granquist | Physical Therapy Assistant | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2019-07-15 |
1003468539 | Laura Jeanne Houfek | Occupational Therapist | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2019-07-15 |
1497307235 | Shaun Michael Sperr | Physical Therapist | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2019-07-11 |
1285192252 | Chamaera Sowell | Social Worker | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2019-03-07 |
1932665858 | Amy Kirsten Maynard | Registered Nurse | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2019-02-15 |
1578031779 | Caroline Betty Muthuri | Nurse Practitioner | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2018-11-06 |
1841783131 | Symphony Michelle Moser | Speech-Language Pathologist | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2018-06-11 |
1861989204 | Bethany Peterson | Physical Therapy Assistant | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2018-04-20 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
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Taxonomy Code | 103TC0700X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396841318 | Karen L King | Psychologist | 6401 University Ave Ne Suite 304, Bhsi LLC, Fridley, MN 55432-4344 | 2006-09-16 |
1710529003 | Amy Stignani | Psychologist | 480 Osborne Rd Ne Ste 260, Fridley, MN 55432-2866 | 2019-10-08 |
1578965398 | Brian Kovach | Psychologist | 480 Osborne Rd Ne Ste 260, Fridley, MN 55432-2866 | 2014-09-24 |
1225377088 | Meghan Doris Miller | Psychologist | 480 Osborne Rd Ne, Suite 260 - Mr 48260, Fridley, MN 55432-2773 | 2013-02-13 |
1932408549 | Richard Allen Mclellan | Psychologist | 7260 University Ave Ne, #235, Fridley, MN 55432-3126 | 2011-03-22 |
1164506952 | Laura Sue Henson | Psychologist | 6401 University Ave Ne, Bhsi LLC Suite 304, Fridley, MN 55432-4344 | 2006-10-25 |
1992801955 | Joseph Michael Steger | Psychologist | 6401 University Ave Ne, Suite 304 Bhsi LLC, Fridley, MN 55432-4344 | 2006-09-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1841899291 | Charlotte Mae Gerth Haanen | Psychologist | 2805 Cliff Rd E, Burnsville, MN 55337-4095 | 2020-10-17 |
1386251148 | Andrew Charles Weis | Psychologist | 158 Water St N Ste 1, Northfield, MN 55057-2125 | 2020-09-25 |
1861008567 | Natalia V Potapova | Psychologist | 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 | 2020-09-17 |
1720691884 | Oluwatosin Alabi | Psychologist | 4124 Quebec Ave N Ste 307, New Hope, MN 55427-1241 | 2020-08-28 |
1962014167 | Kate Esterline | Psychologist | 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 | 2020-08-19 |
1013528207 | Stephen Sean Jenkins | Psychologist | 720 Fourth Ave. S., Eastman Hall 305, Saint Cloud, MN 56301 | 2020-08-12 |
1699392266 | Jacqueline Suresh Layton | Psychologist | 17324 Glencoe Ave, Lakeville, MN 55044-7429 | 2020-06-30 |
1760016109 | Cori Miller | Psychologist | 7300 Metro Blvd Ste 400, Edina, MN 55439-2307 | 2020-02-25 |
1831722594 | Collaboration for Psychological Wellness, LLC | Psychologist | 12000 Portland Ave Ste 120, Burnsville, MN 55337-4469 | 2020-02-20 |
1780214601 | Jennifer Jacqueline Felinski Kurtz | Psychologist | 16688 Kentucky Ave, Lakeville, MN 55044-4616 | 2020-01-20 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.