Daniel J Lofgren, MS LP
Individual provider Active NPI Clinical Psychologist · Orr, MN
NPI 1205937604 · NPPES record last updated Feb 22, 2014
Key facts
- NPI
- 1205937604
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- LP2977 (MN)
- Practice address
- 10574 Willow River Rd
Orr, MN 55771-9055 - Phone
- (218) 780-2992
- NPI assigned
- Sep 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP2977 | MN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP2977 | MN | Yes |
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
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 667518200 | Medicaid | MN |
Other providers in Orr, MN
- Melissa Hawk
- Raymond Lawrence Hawk
- Charles R Helleloid
- Jane Marie Lawrenz
- Crystal Lee Lobe
- Theresa Ann Morrison
- Paul Rasmussen
- Michael Todd Rowlette
All providers in Orr, MN · Clinical Psychologist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.