MARDELLE BRANDT PEARSON (NPI# 1922151596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922151596 |
| Entity Type | Individual |
| Full Name | MARDELLE BRANDT PEARSON |
| Credential | M.A. L.P. |
| Practice Address |
2172 Midland View Ct N Roseville MN 55113-5304 |
| Practice Telephone | 6122673446 |
| Mailing Telephone | 6122673446 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 103T00000X | Psychologist | LP2890 | MN | Behavioral Health & Social Service Providers |
| X | 103TC1900X |
Psychologist Specialization: Counseling |
LP2890 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | BCBS | 13434PE | 01 |
| MN | BCBS INDIVIDUAL | 1G086PE | 01 |
| Street Address |
2172 MIDLAND VIEW CT N |
| City | ROSEVILLE |
| State | MN |
| Zip Code | 55113-5304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384376 | Zachary Mattson | Physician Assistant | Regus Coworking Space 2355 Highway 36 West, Suite 400, Office #427, Roseville, MN 55113 | 2019-12-23 |
| 1467010330 | Ahmed Issa | Student in an Organized Health Care Education/Training Program | 1550 Larpenteur Ave W, Apt 235, St Paul, MN 55113 | 2019-06-05 |
| 1821653833 | Suite Living Senior Care of Little Canada | Assisted Living Facility | 2740 Rice Street, Little Canada, MN 55113 | 2019-05-06 |
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1588138473 | Applewood Home Health Care, LLC | Home Health | 2021 E Hennepin Avenue # 402-1, Minneapolis, MN 55113 | 2019-01-14 |
| 1699251520 | Optum Infusion Services 500, Inc. | Durable Medical Equipment & Medical Supplies | 2685 Patton Rd, Roseville, MN 55113 | 2018-07-13 |
| 1083104145 | Suite Living Senior Care of Roseville | Assisted Living Facility | 197 County Road B2 W, Roseville, MN 55113 | 2018-05-15 |
| 1477055796 | Sunrise Residential Services LLC | Home Health | 216 Maple Ln, Roseville, MN 55113 | 2018-03-02 |
| 1194223024 | Alissa Hoff | Specialist | 1595 Mn 36 - 584 10 Rosedale Center, Roseville, MN 55113 | 2018-01-25 |
| 1841705118 | Kingsland Care Services Incorporated | Case Management | 2301 Rice Street, Suite 101, Roseville, MN 55113 | 2017-12-08 |
| Find all providers in zip 55113 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902370505 | Diverse Assessments and Treatment, LLC | Psychologist | 1935 Cty Rd B2 W Ste 270, Roseville, MN 55113 | 2019-01-16 |
| 1477918654 | William Hayward Staso | Psychologist | 2137 Rhodes Ln, Roseville, CA 95747-9024 | 2015-12-15 |
| 1073773651 | John Honebrink | Psychologist | 1700 W Hwy 36, 210 Rosedale Towers, Roseville, MN 55113 | 2008-06-17 |
| 1063610004 | Chassity Angeny-showalter | Psychologist | 1741 E Roseville Pkwy, Suite 200, Roseville, CA 95661-6449 | 2007-07-10 |
| 1932321486 | Thanh Son Thi Nguyen-kelly | Psychologist | 1315 West Larpenteur Suite I, Roseville, MN 55113 | 2007-05-03 |
| 1073669313 | Albert and Associates | Psychologist | 1700 Highway 36 W, Suite 516, Roseville, MN 55113-4034 | 2007-01-27 |
| 1689737694 | Gloria S Simard | Psychologist | 406 Sunrise Ave Ste 220, Roseville, CA 95661-4100 | 2006-12-19 |
| 1568521524 | Margaret L Mcchesney | Psychologist | 3025 Simpson St, Roseville, MN 55113-1650 | 2006-12-06 |
| 1962580951 | John M. Kendra | Psychologist | 2130 Professional Dr Ste 220, Roseville, CA 95661-3780 | 2006-11-01 |
| 1033295456 | Diane J Huisinga | Psychologist | 729 Sunrise Ave Ste 101, Roseville, CA 95661-4504 | 2006-10-27 |
| Find all providers in ROSEVILLE | ||||
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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.