Active NPI
Asha K. Mukherjee, PHD, LP
- Clinical Psychologist
- Plymouth, MN
National Provider Identifier
1215034863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP1269
- Practice address
- 4205 Lancaster LN N
Suite 107
Plymouth, MN 55441-1700 - Phone
- (763) 553-7820
- Fax
- (763) 383-0598
- NPI assigned
- Sep 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP1269 | MN | Primary |
Addresses
Primary practice location
4205 Lancaster LN N
Suite 107
Plymouth, MN 55441-1700
Mailing address
4205 Lancaster LN N
Suite 107
Plymouth, MN 55441-1700
Phone (763) 553-7820
Other identifiers 12
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 167287 | Other | COMPSYCH ID NO. | |
| TAX ID NO. | Other | FIRST HEALTH | |
| 46702MU | Other | BLUECROSSBLUESHIELD ID | |
| 6166758 | Other | UNITED BEH. HEALTH | |
| 136932 | Other | UCARE PROV. ID | |
| 102142 | Other | LIFERA PROV ID NO. | |
| TAX ID NO. | Other | UNITED HEALTHCARE | |
| TAX ID NO. | Other | HORIZON BEHAVIORAL SRVCS. | |
| 990991020058 | Other | PREFD ONE & CIGNA ID | |
| TAX ID NO. | Other | FRIST HEALTH PROVIDER | |
| TAX ID NO. | Other | MATRIX PSYCH SERVICES | |
| TAX ID NO. | Other | TRICARE (CHAMPUS) |
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
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1215034863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 LANCASTER LN N",
"address_2": "SUITE 107",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554411700",
"telephone_number": "763-553-7820",
"fax_number": "763-383-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4205 LANCASTER LN N",
"address_2": "SUITE 107",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554411700",
"telephone_number": "763-553-7820",
"fax_number": "763-383-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUKHERJEE",
"first_name": "ASHA",
"middle_name": "K.",
"name_prefix": "Dr.",
"credential": "PHD, LP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-17",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP1269",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COMPSYCH ID NO.",
"identifier": "167287",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "TAX ID NO.",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSSBLUESHIELD ID",
"identifier": "46702MU",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED BEH. HEALTH",
"identifier": "6166758",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE PROV. ID",
"identifier": "136932",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LIFERA PROV ID NO.",
"identifier": "102142",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "TAX ID NO.",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON BEHAVIORAL SRVCS.",
"identifier": "TAX ID NO.",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFD ONE & CIGNA ID",
"identifier": "990991020058",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FRIST HEALTH PROVIDER",
"identifier": "TAX ID NO.",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MATRIX PSYCH SERVICES",
"identifier": "TAX ID NO.",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE (CHAMPUS)",
"identifier": "TAX ID NO.",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.