DR. LISA ETHERAPY


Address: 3539 Douglas Dr N, Minneapolis, MN 55422-2415
Phone: 6126421355

DR. LISA ETHERAPY (NPI# 1770120933) 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) 1770120933
Entity Type Organization
Organization Name DR. LISA ETHERAPY
Practice Address 3539 Douglas Dr N
Minneapolis
MN 55422-2415
Practice Telephone 6126421355
Practice Fax Number 6127567059
Mailing Telephone 6126421355
Mailing Fax Number 6127567059
Enumeration Date 2019-12-06
Last Update Date 2019-12-06
Authorized Official Name DR. LISA EILEEN LOVELACE (OWNER, CLINICAL PSYCHOLOGY)
Authorized Official Telephone 6126421355
Authorized Official Credential PSYD
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 2084P0800X Psychiatry & Neurology
Specialization: Psychiatry
Allopathic & Osteopathic Physicians
N 101YM0800X Counselor
Specialization: Mental Health
Behavioral Health & Social Service Providers
N 364SP0808X Clinical Nurse Specialist
Specialization: Psych/Mental Health
Physician Assistants & Advanced Practice Nursing Providers
N 1041C0700X Social Worker
Specialization: Clinical
Behavioral Health & Social Service Providers
N 106H00000X Marriage & Family Therapist Behavioral Health & Social Service Providers
Y 103TC0700X Psychologist
Specialization: Clinical
Behavioral Health & Social Service Providers

Other Provider/Organization Names

Other Name Type Code
Synergy eTherapy Doing Business As Name - Organization

Office Location

Street Address 3539 DOUGLAS DR N
City MINNEAPOLIS
State MN
Zip Code 55422-2415

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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1861008567 Natalia V Potapova Psychologist 701 Park Ave # S1.110, Minneapolis, MN 55415-1623 2020-09-17
1962014167 Kate Esterline Psychologist 2724 University Ave Se Ste B, Minneapolis, MN 55414-3210 2020-08-19
1831740216 Seth Gordon Disner Psychologist 1 Veterans Dr # B68-2, Minneapolis, MN 55417-2309 2019-09-26
1366090763 Healing Therapy LLC Psychologist 1813 S 6th St Ste 201, Minneapolis, MN 55454-1208 2019-08-28
1891340469 Karin Fisher Psychologist 701 Park Ave # S1.260, Minneapolis, MN 55415-1623 2019-08-09
1053881698 Lauren Michelle Scholder Psychologist 401 Main St Se Apt 7009, Minneapolis, MN 55414 2018-11-27
1902306038 Ksa Psychological Services, LLC Psychologist 5603 Chicago Ave., Minneapolis, MN 55417 2018-02-15
1689030231 Oliver Ross Psychology and Consulting LLC Psychologist 3802 Grand Ave S, Suite A, Minneapolis, MN 55409-1233 2016-01-13
1295100881 Oliver Ross Psychologist 3802a Grand Avenue South, Minneapolis, MN 55409 2015-12-08
1841664190 Lakes Wellness Center LLC Psychologist 3248 Stevens Ave, Minneapolis, MN 55408-3214 2015-11-24
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Competitor

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City MINNEAPOLIS
Zip Code 55422

Improve Information

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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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