Active NPI
Mark Lynn Miller, PSY.D., L.P.
- Group Psychotherapy Psychologist
- Minneapolis, MN
National Provider Identifier
1184665390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Group Psychotherapy Psychologist
- License
- LP2306
- Practice address
- 800 E 28TH St
#17701
Minneapolis, MN 55407-3723 - Phone
- (612) 863-5327
- Fax
- (612) 863-2596
- NPI assigned
- Jun 9, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP2306 | MN | |
| Psychologist | 103T00000X | LP2306 | MN | |
| Group Psychotherapy Psychologist | 103TP2701X | LP2306 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St
#17701
Minneapolis, MN 55407-3723
Mailing address
3452 46TH Ave S
Minneapolis, MN 55406-2931
Phone (612) 722-7168
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1012262 | Other | FM | PREFERRED ONE |
| 263S5MI | Other | MN | BLUE CROSS/BLUE |
| 61-77458 | Other | FM | UBH/SELECTCARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP2306 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1184665390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3452 46TH AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554062931",
"telephone_number": "612-722-7168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"address_2": "#17701",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073723",
"telephone_number": "612-863-5327",
"fax_number": "612-863-2596"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MARK",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PSY.D., L.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP2306",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP2306",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "MN",
"license": "LP2306",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED ONE",
"identifier": "1012262",
"state": "FM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE",
"identifier": "263S5MI",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH/SELECTCARE",
"identifier": "61-77458",
"state": "FM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, 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.