Active NPI
Jeffry Alan Cottle, MA, LP
- Clinical Psychologist
- Saint Paul, MN
National Provider Identifier
1003853292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP0480
- Practice address
- 4164 Hemlock LN
Saint Paul, MN 55127-6111 - Phone
- (651) 308-7176
- NPI assigned
- May 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP0480 | MN | Primary |
Addresses
Primary practice location
4164 Hemlock LN
Saint Paul, MN 55127-6111
Mailing address
4164 Hemlock LN
Saint Paul, MN 55127-6111
Phone (651) 308-7176
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP0480 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1003853292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4164 HEMLOCK LN",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551276111",
"telephone_number": "651-308-7176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4164 HEMLOCK LN",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551276111",
"telephone_number": "651-308-7176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COTTLE",
"first_name": "JEFFRY",
"middle_name": "ALAN",
"credential": "MA, LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP0480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.