MEDICARE: DR. ROBERTA MARY SINGERHOUSE PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist	LP5319	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1629372909	OTHER	MN	BLUE CROSS AND BLUE SHIELD OF MINNESOTA AND BLUE PLUS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629372909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERTA MARY SINGERHOUSE PSYD

Provider Business Mailing Address
First Line	:	570 ASBURY ST STE 206
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1850
Country	:	US
Telephone Number	:	651-528-4219
Fax Number	:

Provider Business Practice Location Address
First Line	:	570 ASBURY ST STE 206
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55104-1850
Country	:	US
Telephone Number	:	651-528-4219
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/31/2010
Last Update Date	:	03/17/2018

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