Brad William Houghton, PSYD, LP

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

4812 Issued in MN

Practice address

5019 38TH Ave S
Minneapolis, MN 55417-1662

Phone

(612) 308-7038

NPI assigned

May 17, 2007

Last updated

Mar 19, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Rosenberg Center Assessment and Treatment for Children & Families PA

  • Developmental Disabilities Clinic/Center
  • Roseville, MN
  • NPI 1033347331
  Medicare reassignment NPD
• Sunrise Wellness, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Otsego, MN
  • NPI 1790309813
  Medicare reassignment NPD
• Brad W Houghton PSYD LP LLC

  • Point of Service
  • Saint Paul, MN
  • NPI 1639588643
  Authorized official Same address or phone
• Insights Psychology, LLC

  • Clinical Psychologist
  • Hastings, MN
  • NPI 1649776998
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710806400000",
    "number": "1053528125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5019 38TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171662",
            "telephone_number": "612-308-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5019 38TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554171662",
            "telephone_number": "612-308-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOUGHTON",
        "first_name": "BRAD",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "PSYD, LP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "4812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Houda Chiropractic Clinic Inc
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• Abdullahi Houfaneh
• Thomas Houghland, MD
• Brian Anthony Houle, RN
• Athena Houmas-Schulte
• Joseph Hounshell, CRNA
• House of Charity, Inc.
• House of Heroes Inc

• Clinical Child & Adolescent Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Child & Adolescent Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.