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ST. CLOUD NEUROBEHAVIORAL ASSOCIATES PA NPI 1043860109


NPI Information

NPI: 1043860109
Provider Name: ST. CLOUD NEUROBEHAVIORAL ASSOCIATES, PA
Classification: Psychologist - 103TB0200X
Entity Type: Organization

Specialization: Cognitive & Behavioral

CLIA Number: 24D2240653

Address:
3812 8TH ST N STE 200
SAINT CLOUD, MN
ZIP 56303
Phone: (320) 253-3833
Get Directions

ST. CLOUD NEUROBEHAVIORAL ASSOCIATES, PA is a cognitive and behavioral psychologist in Saint Cloud, MN. The provider is a psychologist who reflects an experimental-clinical approach distinguished by use of principles of human learning and development and theories of cognitive processing to promote meaningful change in maladaptive human behavior and thinking. ST. CLOUD NEUROBEHAVIORAL ASSOCIATES, PA NPI is 1043860109. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3812 8TH ST N STE 200
SAINT CLOUD, MN
ZIP 56303-421
Phone: (320) 253-3833
Fax: (320) 253-5741

The provider's authorized official is Annie L Vogel .
The authorized official title is Office Manager and has the following contact phone number (320) 253-3833.

The CLIA number assigned to this NPI record is 24D2240653 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/19/2019 and was last updated on 9/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TB0200XPsychologistCognitive & BehavioralYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C03196MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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