NPIMap

Organization Active NPI

Kidwell Psychological Services LLC

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1265867923
Registry record updated Jun 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP5403 Issued in MN
Legal business name
KIDWELL PSYCHOLOGICAL SERVICES LLC
Practice address
8441 Wayzata Blvd
Suite 160
Minneapolis, MN 55426-1344
Phone
(651) 482-9361
NPI assigned
Sep 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2014

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

Authorized official

Name
Dr. Julia Kidwell, PHD, LP
Title
Licensed Psychologist
Phone
(763) 566-0088

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X LP5403 MN Primary

Addresses

Primary practice location

8441 Wayzata Blvd
Suite 160
Minneapolis, MN 55426-1344

Mailing address

8441 Wayzata Blvd
Suite 160
Minneapolis, MN 55426-1344
Phone (651) 482-9361

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1378944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403049600000",
    "number": "1265867923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8441 WAYZATA BLVD",
            "address_2": "SUITE 160",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261344",
            "telephone_number": "651-482-9361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8441 WAYZATA BLVD",
            "address_2": "SUITE 160",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554261344",
            "telephone_number": "651-482-9361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDWELL PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-12",
        "last_updated": "2014-06-18",
        "status": "A",
        "authorized_official_last_name": "KIDWELL",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "763-566-0088",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LP"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP5403",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 18, 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.