Individual provider Active NPI

Cindy Dolby Nollette, M.A.,L.P.

  • Psychologist
  • Edina, MN
National Provider Identifier
1114067063
Registry record updated Jun 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LPO371 Issued in MN
Practice address
6600 France Ave S
Suite 635
Edina, MN 55435-1805
Phone
(952) 922-5427
Fax
(612) 922-4189
NPI assigned
Feb 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LPO371 MN Primary

Addresses

Primary practice location

6600 France Ave S
Suite 635
Edina, MN 55435-1805

Mailing address

6600 France Ave. S
Edina, MN 55435-1877
Phone (952) 922-5427

Other identifiers 1

IdentifierTypeStateIssuer
26-005-3617OtherMNFEDERAL TAX ID #

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

LicenseStateTypeSpecialty
LPO371MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244592000000",
    "number": "1114067063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE. S",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351877",
            "telephone_number": "952-922-5427",
            "fax_number": "952-922-9404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6600 FRANCE AVE S",
            "address_2": "SUITE 635",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554351805",
            "telephone_number": "952-922-5427",
            "fax_number": "612-922-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLLETTE",
        "first_name": "CINDY",
        "middle_name": "DOLBY",
        "name_prefix": "Ms.",
        "credential": "M.A.,L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LPO371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID #",
            "identifier": "26-005-3617",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edina, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.