IRIS SONG (NPI# 1790180503) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790180503 |
| Entity Type | Individual |
| Full Name | IRIS SONG |
| Credential | PSY.D., L.P. |
| Practice Address |
7979 Ranchview Ln N Maple Grove MN 55311-2106 |
| Practice Telephone | 6122038027 |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LP5547 | MN | Behavioral Health & Social Service Providers |
| Street Address |
7979 RANCHVIEW LN N |
| City | MAPLE GROVE |
| State | MN |
| Zip Code | 55311-2106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609391374 | Deborah Lynn Higgins | Foster Care Agency | 8288 Revelwood Place, Maple Grove, MN 55311 | 2017-08-03 |
| 1013457993 | Trillium Chiropractic & Wellness Pa | Chiropractor | 13700 Reimer Dr Suite 250, Maple Grove, MN 55311 | 2017-02-27 |
| 1720535263 | Fischer Vision PC | Optometrist | 13334 Bass Lake Road North, Maple Grove, MN 55311 | 2016-09-01 |
| 1033571062 | Iman Dadras Konestani | Marriage & Family Therapist | 9325 Garland Lane N Apt 108, Mapple Grove, MN 55311 | 2016-03-29 |
| 1902272685 | Todd Archbold | Social Worker | 18153 80th Pl N, Maple Grove, MN 55311 | 2015-08-17 |
| 1144634395 | Petersen Chiropractic Inc. | Chiropractor | 9505 Blackoaks Ln No., Maple Grove, MN 55311 | 2014-06-16 |
| 1972738276 | Sara Jean Bidler | Marriage & Family Therapist | 7026 E Fish Lake Rd, Maple Grove, MN 55311 | 2009-05-16 |
| 1962670026 | Helminger Chiropractic, P.a. | Chiropractor | 9479 Garland Lane North, Maple Grove, MN 55311 | 2008-02-12 |
| 1457579450 | Cynthia C Cassel | Physician Assistant | 6300 Wedgewood Way, Maple Grove, MN 55311 | 2007-04-23 |
| 1386860732 | Thomas Triden | Chiropractor | 7494 East Fish Lake Road, Maple Grove, MN 55311 | 2007-04-17 |
| Find all providers in zip 55311 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992940746 | Justin Coulter | Psychologist | 7236 Forestview Lane N., Maple Grove, MN 55369 | 2008-12-09 |
| 1578697173 | Marci Marie Mueller Theisen | Psychologist | 11280 86th Ave N, Maple Grove, MN 55369-4510 | 2007-03-15 |
| 1760532980 | Lynn M Powers | Psychologist | 12403 74th Av N, Maple Grove, MN 55369 | 2007-01-11 |
| 1942223714 | Marcia M Rogers | Psychologist | 7382 Kirkwood Ct, Maple Grove, MN 55369-5270 | 2006-07-25 |
| 1972955268 | Cindi Brockhaus | Psychologist | 13603 80th Cir N, Maple Grove, MN 55369 | 2016-07-11 |
| 1124490578 | Teresa Biehn | Psychologist | 9555 Upland Ln N, Maple Grove, MN 55369-4485 | 2015-10-26 |
| 1033585914 | Michaela Monetti | Psychologist | 14500 99th Ave N, Maple Grove, MN 55369-4730 | 2015-08-14 |
| 1326463944 | Heidi Kopacek | Psychologist | 11280 86th Ave N, Maple Grove, MN 55369-4510 | 2014-02-19 |
| 1124370358 | Elizabeth Anne Heidenreich | Psychologist | 13603 80th Cir N, Maple Grove, MN 55369-8961 | 2012-10-11 |
| 1760790828 | Stacey Lynn Nelson | Psychologist | 11280 86th Ave N, Maple Grove, MN 55369-4510 | 2010-09-22 |
| Find all providers in MAPLE GROVE | ||||
| City | MAPLE GROVE |
| Zip Code | 55311 |
Please comment or provide details below to improve the information on IRIS SONG.
| 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.