| Susan Borden Psych | |
|
2303 Wycliff St Ste W210 Saint Paul MN 55114-1272 | |
| (612) 424-0434 | |
| (877) 905-7069 |
| Full Name | Susan Borden Psych |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2303 Wycliff St Ste W210, Saint Paul, Minnesota |
| Authorized Official Name and Position | Susan Borden (OWNER) |
| Authorized Official Contact | 6124240434 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Borden Psych 104 Seymour Ave Se Minneapolis MN 55414-3558 Ph: (612) 424-0434 | Susan Borden Psych 2303 Wycliff St Ste W210 Saint Paul MN 55114-1272 Ph: (612) 424-0434 |
| NPI Number | 1780313478 |
|---|---|
| Provider Enumeration Date | 06/08/2022 |
| Last Update Date | 05/19/2026 |
| Certification Date | 05/19/2026 |
| Medicare PECOS PAC ID | 4688011612 |
|---|---|
| Medicare Enrollment ID | O20240326001340 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780313478 | NPI | - | NPPES |
| Provider Name | Heidi Jo Titze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902201155 PECOS PAC ID: 7214252048 Enrollment ID: I20150218002462 |
| Provider Name | Susan Lee Borden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427692060 PECOS PAC ID: 1557760964 Enrollment ID: I20210604000055 |
| Provider Name | Amy M Wheelecor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164071148 PECOS PAC ID: 9638568447 Enrollment ID: I20211117001669 |
| Provider Name | Josie Camille Brinda Ridpath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881326668 PECOS PAC ID: 8022494418 Enrollment ID: I20221010000306 |
| Provider Name | Katherine Elizabeth Goodman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467017095 PECOS PAC ID: 1951749761 Enrollment ID: I20240329000150 |
| Provider Name | Katherine Rutherford Mcdonnell |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1114484706 PECOS PAC ID: 8022456789 Enrollment ID: I20240401002974 |
| Provider Name | Caroline Lynn Soon Stark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043825946 PECOS PAC ID: 4385082049 Enrollment ID: I20240401003032 |
| Provider Name | Gregory John Lee Marsh |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356121396 PECOS PAC ID: 5092153924 Enrollment ID: I20240410003030 |
| Provider Name | Alexandra Ann Stanger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790490373 PECOS PAC ID: 9931649258 Enrollment ID: I20240912002375 |
| Provider Name | Kelly Jean Grossman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629897160 PECOS PAC ID: 5890220784 Enrollment ID: I20241202002750 |
| Provider Name | Kelly Ann Kennedy-johnson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477256428 PECOS PAC ID: 8224554126 Enrollment ID: I20250423003444 |
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