PATHWAYS PSYCHOLOGY ON GRAND, PLLC (NPI# 1649281676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649281676 |
Entity Type | Organization |
Organization Name | PATHWAYS PSYCHOLOGY ON GRAND, PLLC |
Practice Address |
1053 Grand Ave Suite 116 Saint Paul MN 55105-3022 |
Practice Telephone | 6512870931 |
Practice Fax Number | 6512870967 |
Mailing Telephone | 6512870931 |
Mailing Fax Number | 6512870967 |
Enumeration Date | 2006-08-11 |
Last Update Date | 2008-11-21 |
Authorized Official Name | DR. JILL R LEBLOND (HIPAA OFFICER) |
Authorized Official Telephone | 6512870931 |
Authorized Official Credential | PSYD, LP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MN | BLUE CROSS BLUE SHIELD ID | 626K2PA | 01 |
MN | 9374051000 | 05 |
Street Address |
1053 GRAND AVE SUITE 116 |
City | SAINT PAUL |
State | MN |
Zip Code | 55105-3022 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013921923 | Ihs Grand Avenue Pllp | Chiropractor | 1053 Grand Ave, Suite 114, Saint Paul, MN 55105-3022 | 2006-07-28 |
1659623247 | Laura Ann Evans | Massage Therapist | 1053 Grand Ave, Suite 109, Saint Paul, MN 55105-3022 | 2012-10-08 |
1699026187 | Mindy Lee Geraets | Massage Therapist | 1053 Grand Ave, Suite 109, Saint Paul, MN 55105-3022 | 2012-09-25 |
1154696813 | Healthsource of St. Paul- Grand | Clinic/Center | 1053 Grand Ave, Suite #114, Saint Paul, MN 55105-3022 | 2012-03-14 |
1346567609 | Healthquest Sports Injury and Chiropractic Center | Health Maintenance Organization | 1053 Grand Ave, 114, Saint Paul, MN 55105-3022 | 2010-04-27 |
1184959249 | Bradley Vernon Northrup | Chiropractor | 1053 Grand Ave, #114, Saint Paul, MN 55105-3022 | 2009-10-07 |
1104021435 | Bryan Chiropractic, P.a. | Chiropractor | 1053 Grand Ave, Suite 114, Saint Paul, MN 55105-3022 | 2007-06-18 |
1508968058 | Lisa Quinn | Social Worker | 1053 Grand Ave, Suite 110, Saint Paul, MN 55105-3022 | 2006-09-05 |
1164433165 | Jill Raquel Leblond | Psychologist | 1053 Grand Ave, Suite 116, Saint Paul, MN 55105-3022 | 2006-08-11 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437704020 | Grand Avenue Smiles | Dentist | 1845 Grand Avenue, St. Paul, MN 55105 | 2019-08-09 |
1205304839 | Michelle Marie Loken Price | Acupuncturist | 877 Lincoln Ave, Saint Paul, MN 55105 | 2018-11-13 |
1326566936 | Becky Lynn Lawyer | Counselor | 1704 Palace Ave, St Paul, MN 55105 | 2017-09-04 |
1679020226 | Internal Revolution Counseling and Consulting, L.L.C. | Psychologist | 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 | 2016-09-01 |
1487059689 | Jennifer Mason | Lactation Consultant, Non-RN | 1382 Summit Ave, Saint Paul, MN 55105 | 2014-10-30 |
1679818850 | Marc Lane Wolfson | Registered Nurse | 1148 Grand Avenue, St. Paul, MN 55105 | 2012-11-29 |
1457602781 | Charting Your Success | Social Worker | 2050 St Clair Avenue, Suite 1e, St Paul, MN 55105 | 2012-09-26 |
1871867549 | Stacia Hanson Ma Lp LLC | Psychologist | 889 Grand Avenue, Suite 203, St Paul, MN 55105 | 2012-02-28 |
1265718142 | Caitlin Marie Young | Midwife | 968 Grand Ave., St. Paul, MN 55105 | 2011-10-24 |
1659512622 | Wellness Cooperative LLC | Chiropractor | 976 Grand Ave., St. Paul, MN 55105 | 2009-03-20 |
Find all providers in zip 55105 |
Taxonomy Code | 261QM0801X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Mental Health (Including Community Mental Health Center) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1720693146 | Serene Therapy and Counseling Services LLC | Clinic/Center | 777 Berry St Apt 400b, Saint Paul, MN 55114-4006 | 2020-09-11 |
1326678004 | Adrift Counseling, LLC | Clinic/Center | 1032 Grand Ave # 201, Saint Paul, MN 55105-3064 | 2020-01-22 |
1720644321 | Sunrise Recovery Services, LLC | Clinic/Center | 1375 Saint Anthony Ave Ste 202-01, Saint Paul, MN 55104-4006 | 2019-05-20 |
1699249342 | Indigo Counseling Center | Clinic/Center | 2388 University Ave W # 202, Saint Paul, MN 55114-1769 | 2019-01-16 |
1932608916 | Pioneer Healing and Restoration Services Inc | Clinic/Center | 1885 University Ave W Ste 300a, Saint Paul, MN 55104-3462 | 2018-02-06 |
1467950857 | Samantha Rivera Healing Center Inc | Clinic/Center | 1032 Grand Ave Ste 202, Saint Paul, MN 55105-3064 | 2018-01-31 |
1851759088 | Lhc Consulting, PC | Clinic/Center | 1619 Dayton Ave Ste 325, Saint Paul, MN 55104-6206 | 2016-02-02 |
1659717502 | Twin Cities Center for Psychology & Wellness, LLC | Clinic/Center | 1350 Energy Ln Ste 110a, Saint Paul, MN 55108-5254 | 2013-05-20 |
1871879759 | Natural Connections Learning Center | Clinic/Center | 1801 Dudley Ave, Saint Paul, MN 55108-1003 | 2011-10-24 |
1417941063 | Center for Psychological Services for Twin Cities, Pa | Clinic/Center | 245 Ruth St N, Saint Paul, MN 55119-4323 | 2005-09-09 |
Find all providers in SAINT PAUL |
City | SAINT PAUL |
Zip Code | 55105 |
Please comment or provide details below to improve the information on PATHWAYS PSYCHOLOGY ON GRAND, PLLC.
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.