ROCHESTER CENTER FOR AUTISM, INC


Address: 1220 4th Ave Sw, Rochester, MN 55902-3834
Phone: 5074243234

ROCHESTER CENTER FOR AUTISM, INC (NPI# 1730179995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1730179995
Entity Type Organization
Organization Name ROCHESTER CENTER FOR AUTISM, INC
Practice Address 1220 4th Ave Sw
Rochester
MN 55902-3834
Practice Telephone 5074243234
Practice Fax Number 5074243235
Mailing Telephone 5074243234
Mailing Fax Number 5074243235
Enumeration Date 2005-10-27
Last Update Date 2020-08-22
Authorized Official Name MRS. MANDY MARIE EGGERT (DIRECTOR/PROGRAM SUPERVISOR)
Authorized Official Telephone 5074243234
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TB0200X Psychologist
Specialization: Cognitive & Behavioral
LP0911 MN Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MN BCBS OF MN PROVIDER # 265K2RO 01

Office Location

Street Address 1220 4TH AVE SW
City ROCHESTER
State MN
Zip Code 55902-3834

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1912442898 Esperanza Torres Dental Hygienist 903 West Center Street, Suite 130, United Way Bldg, Rochester, MN 55902 2016-12-30
1578971149 Alduz Inri Surio Cabasa Student in an Organized Health Care Education/Training Program 609 1st Street Sw, Unit 102, Rochester, MN 55902 2014-07-28
1679901854 Julie Erickson Dental Hygienist United Way Building Suite #208, Rochester, MN 55902 2013-10-24
1619313590 Mercedes K Schulz Dental Hygienist 13394th Ave Sw, Rochester, MN 55902 2013-05-17
1093087389 Sarah Jean Dennison Clinic/Center 930 West Center Street, Suite 208 United Way Bldg, Rochester, MN 55902 2012-02-01
1467732156 Angela Elizabeth Peters Registered Nurse 1450 2nd Avenue Sw, Rochester, MN 55902 2011-08-25
1528350071 Emily Zahasky Kraft Pharmacist 204 1st Street Sw, Rochester, MN 55902 2011-05-03
1093021982 Sherry Dawn Boutcher Dental Hygienist 903 West Center Street Suite 208, United Way Building, Rochester, MN 55902 2010-08-30
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Taxonomy Information

Taxonomy Code 103TB0200X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Cognitive & Behavioral

Taxonomy Definition

Definition to come...
Notes: [1/1/2007: title modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225466089 Miri Arie Psychologist 1815 S Clinton Ave., Suite 630, Rochester, NY 14618 2013-10-14
1588952303 Edward L Deci Psychologist 429 Meliora Hall, University of Rochester, Rochester, NY 14627-0266 2011-07-13
1689810871 Linda Marie-latronica Bull Psychologist 850 W University Dr Ste C, Rochester, MI 48307-1845 2008-12-18
1093897498 Quixote Consulting Psychologist 7038 191st Ave Sw, Rochester, WA 98579-8719 2006-10-19
1811416670 Gina Dilly Psychologist 300 1st Ave Nw Ste 200, Rochester, MN 55901-2830 2017-09-13
1124498332 Stephanie Geter Psychologist 110 Allens Creek Rd, Rochester, NY 14618-3304 2015-09-30
1770908659 Frederick D Kemp Psychologist 7038 191st Ave Sw, Rochester, WA 98579-8719 2014-02-28
1902236078 Jill Renea Snuggerud Psychologist 200 1st St Sw, Rochester, MN 55905-0001 2013-11-26
1235148107 Patricia A Gaudieri Psychologist 601 Elmwood Ave, Rochester, NY 14642-8409 2006-08-07
1316975774 Kenneth Schwarcz Psychologist 1101 W University Dr, Attn: Susan Murray, Rochester, MI 48307-1863 2006-06-28
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Competitor

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City ROCHESTER
Zip Code 55902

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Dataset Information

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.

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