Active NPI
Martha E Dille, M.S. L.P.
- Psychologist
- Minneapolis, MN
National Provider Identifier
1295070415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3470
- Practice address
- 525 Portland Ave
Minneapolis, MN 55415-1533 - Phone
- (612) 964-1778
- NPI assigned
- Nov 28, 2012
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3470 | MN | Primary |
Addresses
Primary practice location
525 Portland Ave
Minneapolis, MN 55415-1533
Mailing address
16982 Dewitte Ave SW
Prior Lake, MN 55372-2310
Phone (952) 237-6168
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354060800000",
"number": "1295070415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16982 DEWITTE AVE SW",
"city": "PRIOR LAKE",
"state": "MN",
"postal_code": "553722310",
"telephone_number": "952-237-6168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 PORTLAND AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554151533",
"telephone_number": "612-964-1778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLE",
"first_name": "MARTHA",
"middle_name": "E",
"credential": "M.S. L.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-28",
"last_updated": "2012-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "3470",
"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 Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.