Kathleen A Daly, MA LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP3212 Issued in MN

Practice address

3005 James Ave S Ste 300
Minneapolis, MN 55408-2590

Phone

(612) 619-2878

NPI assigned

Jan 26, 2023

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 6, 2023 through Nov 6, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Kathleen a Daly Ma LP PC

  • Psychologist
  • Minneapolis, MN
  • NPI 1366492449
  NPD (past) Authorized official

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1093421638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5012 ABBOTT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554102141",
            "telephone_number": "612-512-7250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 JAMES AVE S STE 300",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082590",
            "telephone_number": "612-619-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "KATHLEEN",
        "middle_name": "A",
        "credential": "MA LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP3212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Dalton
• Rachel Dalton, LICSW
• Amy Daly, RN
• David Daly, O.D.
• Julie Christine Daly, LMFT
• Marion Daly
• Michael Daly
• Samuel Daly, MD
• Megan Daman
• Hannah Dambek, PHARMD

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.