DR. LUCAS BOSCO WANGA (NPI# 1881015253) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881015253 |
| Entity Type | Individual |
| Full Name | DR. LUCAS BOSCO WANGA |
| Credential | PH.D. |
| Practice Address |
715 Edgerton Street Merrick Community Services St. Paul MN 55130 |
| Mailing Address |
1311 4th Street South East Suite 13531 Wanga & Associates Minneapolis MN 55414 |
| Practice Telephone | 6123601966 |
| Mailing Telephone | 6123601966 |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
362637 | MN | Behavioral Health & Social Service Providers |
| N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
362637 | MN | Behavioral Health & Social Service Providers |
| N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
362637 | MN | Behavioral Health & Social Service Providers |
| N | 103TS0200X |
Psychologist Specialization: School |
362637 | MN | Behavioral Health & Social Service Providers |
| Street Address |
715 EDGERTON STREET MERRICK COMMUNITY SERVICES |
| City | ST. PAUL |
| State | MN |
| Zip Code | 55130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164904587 | Confident Care LLC | In Home Supportive Care | 1040 Arkwright Street, Saint Paul, MN 55130 | 2018-09-01 |
| 1174865570 | Sarang Patel | Internal Medicine | 401 Phalen Blvd # 41103d, Saint Paul, MN 55130 | 2013-03-23 |
| 1427394501 | Zongxee Lee | Registered Nurse | 1072 Payne Ave, St. Paul, MN 55130 | 2012-12-18 |
| 1740532753 | One Stop Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 1049 Payne Ave Suite C, St Paul, MN 55130 | 2012-10-15 |
| 1689923997 | Alexis Simmons | Counselor | 402 University Ave East, Suite A-127, Saint Paul, MN 55130 | 2012-08-31 |
| 1689804064 | Group Health Plan, Inc. | Durable Medical Equipment & Medical Supplies | 537 Phalen Blvd, Saint Paul, MN 55130 | 2009-07-21 |
| 1477756534 | Chad Everett Christensen | Chiropractor | 1073 Payne Ave, Saint Paul, MN 55130 | 2007-06-07 |
| 1922219021 | Qwik Urgent Care Clinic | Family Medicine | 1239 Payne Avenue, Saint Paul, MN 55130 | 2007-05-24 |
| 1275743981 | Yia Vang | Technician | 1100 Arkwright St., St. Paul, MN 55130 | 2007-05-23 |
| 1346302981 | St. Paul Family Medical Center | Clinic/Center | 1239 Payne Ave, Saint Paul, MN 55130 | 2006-12-13 |
| Find all providers in zip 55130 | ||||
| Taxonomy Code | 103TB0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Cognitive & Behavioral |
| Definition to come... |
| Notes: [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295347854 | Shining Light Skill Building LLC | Psychologist | 3055 Old Highway 8 Ste 106b, St. Anthony, MN 55418 | 2020-08-17 |
| 1245750652 | Sara Vaccarella | Psychologist | 331 W Superior St Ste 300, Duluth, MN 55802-4532 | 2017-06-27 |
| 1780124305 | Families First Counseling Services LLC | Psychologist | 103 S Kingston St, Caledonia, MN 55921-1315 | 2017-03-01 |
| 1598150930 | Nova Bhs | Psychologist | 521 Tanglewood Dr., Shoreview, MN 55126 | 2015-04-02 |
| 1801208566 | Rose Mary Boerboom | Psychologist | 415 N 1st St, #502, Minneapolis, MN 55401-4305 | 2014-05-28 |
| 1992145288 | Rowan P Buckley | Psychologist | 6825 Owen St Ste 201, Loretto, MN 55357-9713 | 2013-07-01 |
| 1063781771 | Julie Ann Gomer | Psychologist | 13700 Reimer Dr N Ste 220, Maple Grove, MN 55311-4548 | 2011-12-26 |
| 1750697587 | Megan Horwitz Plumstead | Psychologist | 1619 Dayton Ave Ste 327, Saint Paul, MN 55104-6495 | 2010-08-31 |
| 1073826913 | Scott Michael Jacoby | Psychologist | 2110 Lyndale Ave S, Minneapolis, MN 55405-3196 | 2010-07-20 |
| 1316178296 | Elaine Marie Miller | Psychologist | 3604 S Oak Cir, Saint Cloud, MN 56301-4616 | 2009-07-27 |
| Find all providers with the same taxonomy | ||||
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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.