Healthcare Provider Details

I. General information

NPI: 1285692277
Provider Name (Legal Business Name): NEIL ROBERT SHIRREFF LICENSED PSYCHOLOGIS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 6TH ST SE
PELICAN RAPIDS MN
56572-4630
US

IV. Provider business mailing address

401 6TH ST SE
PELICAN RAPIDS MN
56572-4630
US

V. Phone/Fax

Practice location:
  • Phone: 218-863-4833
  • Fax:
Mailing address:
  • Phone: 218-863-4833
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberLP1852
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2156
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: