DR. PHYLLIS WHITE PHELAN (NPI# 1366649386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366649386 |
| Entity Type | Individual |
| Full Name | DR. PHYLLIS WHITE PHELAN |
| Credential | PH.D. |
| Practice Address |
570 Asbury St Suite 302 Saint Paul MN 55104-1849 |
| Practice Telephone | 6516445275 |
| Practice Fax Number | 7632011095 |
| Mailing Telephone | 6516445275 |
| Mailing Fax Number | 7632011095 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
LP1119 | MN | Behavioral Health & Social Service Providers |
| Street Address |
570 ASBURY ST SUITE 302 |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55104-1849 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104898642 | Kathleen M Pfaffinger | Psychologist | 570 Asbury St, Suite 103, Saint Paul, MN 55104-1849 | 2006-02-07 |
| 1578008900 | U.S. Healthworks Medical Group of Minnesota, PC | Physical Therapist | 570 Asbury St, Suite 101, Saint Paul, MN 55104-1849 | 2016-12-20 |
| 1124577614 | Malea Stoesz | Counselor | 570 Asbury St, Suite 300, Saint Paul, MN 55104-1849 | 2016-09-26 |
| 1730635277 | Pheng Thao | Counselor | 570 Asbury St, Suite 300, Saint Paul, MN 55104-1849 | 2016-08-25 |
| 1952856627 | Melissa Schoeberl | Counselor | 570 Asbury St, Suite 300, Saint Paul, MN 55104-1849 | 2016-08-23 |
| 1699220418 | Shelby Marx | Counselor | 570 Asbury St, Suite 300, Saint Paul, MN 55104-1849 | 2016-08-22 |
| 1407211154 | Shannon Pollreis-gottschalk | Counselor | 570 Asbury St, Suite 300, Saint Paul, MN 55104-1849 | 2015-12-23 |
| 1134528557 | Practical Therapy LLC | Community/Behavioral Health | 570 Asbury St, Suite 206, Saint Paul, MN 55104-1849 | 2014-08-21 |
| 1407292386 | W.b.garrett Consulting LLC | Community/Behavioral Health | 570 Asbury St, 304-a, Saint Paul, MN 55104-1849 | 2013-05-17 |
| 1013215136 | Stephen M. Hjemboe, Ph.d., LLC | Psychologist | 570 Asbury St, Suite 208, Saint Paul, MN 55104-1849 | 2011-03-14 |
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|---|---|---|---|---|
| 1891339131 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 1600 University Ave West, Suite 12, Room P, Saint Paul, MN 55104 | 2019-10-30 |
| 1629541644 | Michael P Cain | Counselor | 1821 University Ave West, Suite N385, St. Paul, MN 55104 | 2019-01-03 |
| 1295219657 | Awaken Recovery Center L.l.c | Counselor | 400 Suite D 393 North Dunlap, St Paul, MN 55104 | 2018-09-21 |
| 1285115634 | American Current Care of Minnesota PC | Clinic/Center | 570 Asbury St Ste 101, Saint Paul, MN 55104 | 2018-08-23 |
| 1699262501 | B & M Vital Homecare LLC. | Home Health | 1821 University Ave., W., Ste #s334, St. Paul, MN 55104 | 2018-04-16 |
| 1134621600 | Lauren Fullerton | Counselor | 1821 University Ave W., Suite N385, St. Paul, MN 55104 | 2018-03-01 |
| 1265944672 | Megan Manning | Marriage & Family Therapist | 475 Cleveland Ave. N., Suite 316, St. Paul, MN 55104 | 2017-10-26 |
| 1801305131 | Foncham Buma Foncham | Registered Nurse | 856 University Avenue, W, St. Paul, MN 55104 | 2017-09-29 |
| 1750802476 | Ha Vo | Counselor | 451 Lexington Parkway North, St. Paul, MN 55104 | 2017-07-03 |
| 1952831026 | Noble Senior Center Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1094 University Ave W, Saint Paul, MN 55104 | 2017-06-12 |
| Find all providers in zip 55104 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750697587 | Megan Horwitz Plumstead | Psychologist | 1619 Dayton Ave Ste 327, Saint Paul, MN 55104-6495 | 2010-08-31 |
| 1740559699 | Consulting Psychologists Associates | Psychologist | 501 Dale St N, 213, Saint Paul, MN 55103-1914 | 2011-12-22 |
| 1407189251 | John Hansen M.a. Licensed Psychologist LLC | Psychologist | 1600 University Ave W, Suite 400, Saint Paul, MN 55104-3898 | 2009-09-11 |
| 1912196569 | Shannon Kay Garrity | Psychologist | 2388 University Ave W, 202, Saint Paul, MN 55114-1769 | 2007-10-19 |
| 1548475296 | Laura A. Boe | Psychologist | 91 Snelling Ave N, Suite 230, Saint Paul, MN 55104-6753 | 2007-05-14 |
| 1134299167 | Deborah E Fisher | Psychologist | 401 Phalen Blvd, Mc 41104c, Saint Paul, MN 55130-5302 | 2006-11-08 |
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| 1295347854 | Shining Light Skill Building LLC | Psychologist | 3055 Old Highway 8 Ste 106b, St. Anthony, MN 55418 | 2020-08-17 |
| 1245750652 | Sara Vaccarella | Psychologist | 331 W Superior St Ste 300, Duluth, MN 55802-4532 | 2017-06-27 |
| 1780124305 | Families First Counseling Services LLC | Psychologist | 103 S Kingston St, Caledonia, MN 55921-1315 | 2017-03-01 |
| 1598150930 | Nova Bhs | Psychologist | 521 Tanglewood Dr., Shoreview, MN 55126 | 2015-04-02 |
| 1801208566 | Rose Mary Boerboom | Psychologist | 415 N 1st St, #502, Minneapolis, MN 55401-4305 | 2014-05-28 |
| 1881015253 | Lucas Bosco Wanga | Psychologist | 715 Edgerton Street, Merrick Community Services, St. Paul, MN 55130 | 2014-01-02 |
| 1992145288 | Rowan P Buckley | Psychologist | 6825 Owen St Ste 201, Loretto, MN 55357-9713 | 2013-07-01 |
| 1063781771 | Julie Ann Gomer | Psychologist | 13700 Reimer Dr N Ste 220, Maple Grove, MN 55311-4548 | 2011-12-26 |
| 1073826913 | Scott Michael Jacoby | Psychologist | 2110 Lyndale Ave S, Minneapolis, MN 55405-3196 | 2010-07-20 |
| 1316178296 | Elaine Marie Miller | Psychologist | 3604 S Oak Cir, Saint Cloud, MN 56301-4616 | 2009-07-27 |
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| City | SAINT PAUL |
| Zip Code | 55104 |
Please comment or provide details below to improve the information on DR. PHYLLIS WHITE PHELAN.
| 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.