COMMUNITY COUNSELING CLINIC (NPI# 1487739819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487739819 |
| Entity Type | Organization |
| Organization Name | COMMUNITY COUNSELING CLINIC |
| Practice Address |
700 Twelve Oaks Center Dr Ste. 734 Wayzata MN 55391-4401 |
| Mailing Address |
16725 12th Ave N Plymouth MN 55447-3001 |
| Practice Telephone | 9522580668 |
| Practice Fax Number | 6122353384 |
| Mailing Telephone | 7634733692 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | SUE HIERL (OFFICE MANAGER) |
| Authorized Official Telephone | 9522580668 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | LP1597 | MN | Behavioral Health & Social Service Providers |
| Street Address |
700 TWELVE OAKS CENTER DR STE. 734 |
| City | WAYZATA |
| State | MN |
| Zip Code | 55391-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720065345 | Mary Ann Anders Gobar | Psychologist | 700 Twelve Oaks Center Dr, Suite 734, Wayzata, MN 55391-4401 | 2005-12-23 |
| 1629563929 | Novo Behavioral Health | Psychologist | 700 Twelve Oaks Center Dr, Wayzata, MN 55391-4401 | 2018-06-28 |
| 1609374446 | Truyu Health & Wellbeing Pllc | Nurse Practitioner | 700 Twelve Oaks Center Dr, Wayzata, MN 55391-4401 | 2018-01-26 |
| 1235512351 | Natasha Manish Parekh | Psychologist | 700 Twelve Oaks Center Dr, Wayzata, MN 55391 | 2015-07-07 |
| 1669866968 | Tara Carlson | Chiropractor | 700 Twelve Oaks Center Dr, Suite 734, Wayzata, MN 55391-4401 | 2015-03-24 |
| 1821482126 | Avid Health and Wellness Chiropractic | Chiropractor | 700 Twelve Oaks Center Dr, Suite 734, Wayzata, MN 55391-4401 | 2015-03-24 |
| 1972942886 | Dorit Atar | Marriage & Family Therapist | 700 Twelve Oaks Center Dr, Wayzata, MN 55391-4401 | 2013-06-24 |
| 1134404312 | Megan Lynn Bearce | Marriage & Family Therapist | 700 Twelve Oaks Center Dr, Suite 226, Wayzata, MN 55391-4401 | 2011-10-19 |
| 1821387028 | True Care Health Pa | Preferred Provider Organization | 700 Twelve Oaks Center Dr, Suite# 101, Wayzata, MN 55391-4401 | 2011-03-29 |
| 1629306584 | Global Wellness Management Company | Chiropractor | 700 Twelve Oaks Center Dr, Suite 101, Wayzata, MN 55391-4401 | 2009-12-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790386456 | Alexandra Lloyd Conroy | Counselor | 3227 Lake Shore Boulevard, Minnetonka, MN 55391 | 2020-11-07 |
| 1417579178 | Kate Anne Schroeder | Behavioral Analyst | 901 Twelve Oaks Center Drive Suite 934, Wayzata, MN 55391 | 2020-05-15 |
| 1467940478 | Tyler Michael Knutson | Chiropractor | 1421 E Wayzata Blvd, Wayzata, MN 55391 | 2018-04-25 |
| 1427552025 | Emma Nadler, L.L.C. | Counselor | 700 Twelve Oaks Center Dr. #263, Wayzata, MN 55391 | 2018-03-20 |
| 1730687757 | Global Home Care Inc | Home Health | 1001 Twelve Oaks Center Drive, Suite 1018, Wayzata, MN 55391 | 2018-01-24 |
| 1205362472 | Oraphanh Vongpheth Smith | Registered Nurse | 801 Twelve Oaks Center Drive, Suite 822, Wayzata, MN 55391 | 2017-05-10 |
| 1386189272 | Wayzata Endodontics, P.a. | Dentist | 101 Lake Street West, Suite 100, Wayzata, MN 55391 | 2016-12-30 |
| 1952763351 | Watershed Psychological Services | Clinic/Center | 4255 Pheasant Ridge Drive, Suite 412, Blaine, MN 55391 | 2016-03-24 |
| 1477923571 | Robert J. Floren | Marriage & Family Therapist | 801 Twelve Oaks Center Dr Ste 816a, Wayzata, MN 55391 | 2015-10-01 |
| 1194101055 | Bruce Martinson Family & Cosmetic Dentistry | Dentist | 317 E Wayzata Blvd, Wayzata, MN 55391 | 2015-08-03 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568775484 | Celeste Scott | Psychologist | 700 Twelve Oaks Center Dr Ste 103, Wayzata, MN 55391-4411 | 2010-07-20 |
| 1437485190 | Darlene Heimerl | Psychologist | 700 Twelve Oaks Center Dr Ste 734, Wayzata, MN 55391-4450 | 2009-10-30 |
| 1306054663 | Darryl Ross Goetz | Psychologist | 801 Twelve Oaks Center Dr Ste 820a, Wayzata, MN 55391-4640 | 2007-05-19 |
| 1710016043 | Patricia J. Mactaggert | Psychologist | 804 Lake St E, Suite 204, Wayzata, MN 55391-1980 | 2007-03-04 |
| 1407925969 | Roxanna Louise Rutter | Psychologist | 1310 Wayzata Blvd E, Breathing Room, Wayzata, MN 55391-1952 | 2006-11-07 |
| 1093813859 | Sherry Machen | Psychologist | 205 Barry Ave S, #201, Wayzata, MN 55391 | 2006-09-20 |
| 1720065345 | Mary Ann Anders Gobar | Psychologist | 700 Twelve Oaks Center Dr, Suite 734, Wayzata, MN 55391-4401 | 2005-12-23 |
| 1235512351 | Natasha Manish Parekh | Psychologist | 700 Twelve Oaks Center Dr, Wayzata, MN 55391 | 2015-07-07 |
| 1366643868 | Jennifer Ann Ullom | Psychologist | 700 Twelve Oaks Center Dr, Ste 204, Wayzata, MN 55391-4415 | 2007-05-30 |
| 1609996164 | Connie J Greenberg | Psychologist | 801 Twelve Oaks Center Dr, Wayzata, MN 55391-4601 | 2007-03-29 |
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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.