Active NPI
Dawn Elizabeth McClelland, PHD
- Clinical Psychologist
- St Louis Park, MN
National Provider Identifier
1215055587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP3008
- Practice address
- 1660 S Hwy 100
#428
St Louis Park, MN 55416 - Phone
- (763) 541-1973
- Fax
- (952) 938-6969
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- No
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 | LP3008 | MN | Primary |
Addresses
Primary practice location
1660 S Hwy 100
#428
St Louis Park, MN 55416
Mailing address
5211 Malibu Dr
Edina, MN 55436
Phone (763) 541-1973
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP3008 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215055587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5211 MALIBU DR",
"city": "EDINA",
"state": "MN",
"postal_code": "55436",
"telephone_number": "763-541-1973",
"fax_number": "952-938-6969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1660 S HWY 100",
"address_2": "#428",
"city": "ST LOUIS PARK",
"state": "MN",
"postal_code": "55416",
"telephone_number": "763-541-1973",
"fax_number": "952-938-6969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCLELLAND",
"first_name": "DAWN",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP3008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in St Louis Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.