Provider Demographics
NPI:1043545189
Name:THE COMMUNITY CIRCLE, PLLC
Entity Type:Organization
Organization Name:THE COMMUNITY CIRCLE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:M
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-898-7578
Mailing Address - Street 1:14300 NICOLLET CT
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306-4501
Mailing Address - Country:US
Mailing Address - Phone:952-898-7578
Mailing Address - Fax:952-898-7592
Practice Address - Street 1:14300 NICOLLET CT
Practice Address - Street 2:SUITE 207
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-4501
Practice Address - Country:US
Practice Address - Phone:952-898-7578
Practice Address - Fax:952-898-7592
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-03-1206103K00000X
MN495762084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty