Individual provider Active NPI

Daniel J Lofgren, MS LP

  • Clinical Psychologist
  • Orr, MN
National Provider Identifier
1205937604
Registry record updated Feb 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP2977 Issued in MN
Practice address
10574 Willow River Rd
Orr, MN 55771-9055
Phone
(218) 780-2992
NPI assigned
Sep 26, 2006
Last updated
Feb 22, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP2977 MN Primary

Addresses

Primary practice location

10574 Willow River Rd
Orr, MN 55771-9055

Mailing address

10574 Willow River Rd
Orr, MN 55771-9055
Phone (218) 780-2992

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 Science

State licenses

LicenseStateTypeSpecialty
LP2977MNMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393027200000",
    "number": "1205937604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10574 WILLOW RIVER RD",
            "city": "ORR",
            "state": "MN",
            "postal_code": "557719055",
            "telephone_number": "218-780-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10574 WILLOW RIVER RD",
            "city": "ORR",
            "state": "MN",
            "postal_code": "557719055",
            "telephone_number": "218-780-2992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFGREN",
        "first_name": "DANIEL",
        "middle_name": "J",
        "credential": "MS LP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2014-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orr, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2014; 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.