Provider Demographics
NPI:1730388562
Name:JOHN A. LORAAS, PH.D., P.A.
Entity type:Organization
Organization Name:JOHN A. LORAAS, PH.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:LORAAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:952-432-3220
Mailing Address - Street 1:7373 147TH ST W STE 180
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-7689
Mailing Address - Country:US
Mailing Address - Phone:952-432-3220
Mailing Address - Fax:952-891-4622
Practice Address - Street 1:7373 147TH ST W STE 180
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-7689
Practice Address - Country:US
Practice Address - Phone:952-432-3220
Practice Address - Fax:952-891-4622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNMN LP 3963103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN6110518OtherUNITED BEHAVIORAL HEALTH
MN116316OtherU CARE OF MINNESOTA
MN06D65LOOtherBLUE CROSS BLUE SHIELD
MN564021100Medicaid
MN6110518OtherUNITED BEHAVIORAL HEALTH