Active NPI
Marilyn Reichman
- Psychologist
- Brooklyn Center, MN
National Provider Identifier
1083716013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP3634
- Practice address
- 570L Shingle Creek Pkwy
Suite 500
Brooklyn Center, MN 55430 - Phone
- (763) 503-3981
- NPI assigned
- Sep 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP3634 | MN | Primary |
| Registered Nurse | 163W00000X | R-102673-7 | MN |
Addresses
Primary practice location
570L Shingle Creek Pkwy
Suite 500
Brooklyn Center, MN 55430
Mailing address
570L Shingle Creek Parkway
Suite 500
Brooklyn Center, MN 55430
Phone (763) 503-3981
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 62-65802 | Other | MN | MEDICA |
| 076KORE | Other | MN | BLUE CROSS-BLUE SHIELD |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3634 | MN | MD | Psychologist |
| R-102673-7 | MN | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DBT Associates | Psychologist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1083716013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570L SHINGLE CREEK PARKWAY",
"address_2": "SUITE 500",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "55430",
"telephone_number": "763-503-3981"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570L SHINGLE CREEK PKWY",
"address_2": "SUITE 500",
"city": "BROOKLYN CENTER",
"state": "MN",
"postal_code": "55430",
"telephone_number": "763-503-3981"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REICHMAN",
"first_name": "MARILYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-01",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP3634",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "R-102673-7",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "62-65802",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS-BLUE SHIELD",
"identifier": "076KORE",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Center, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.