Active NPI
Laura Ann Whitney, LP
- Clinical Psychologist
- Duluth, MN
National Provider Identifier
1316012867
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP 3078
- Practice address
- 530 E 2ND St
Essentia Health Polinsky Medical Rehab Center
Duluth, MN 55805-1913 - Phone
- (218) 786-5360
- NPI assigned
- Nov 21, 2006
- 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 | LP 3078 | MN | Primary |
Addresses
Primary practice location
530 E 2ND St
Essentia Health Polinsky Medical Rehab Center
Duluth, MN 55805-1913
Mailing address
530 E 2ND St
Essentia Health Polinsky Medical Rehab Center
Duluth, MN 55805-1913
Phone (218) 786-5360
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8753229-00 | Medicaid | MN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP 3078 | MN | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer River Healthcare Center, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Access Hospital
- Deer River, MN
- NPI 1225049018
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452816000000",
"number": "1316012867",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 E 2ND ST",
"address_2": "ESSENTIA HEALTH POLINSKY MEDICAL REHAB CENTER",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051913",
"telephone_number": "218-786-5360"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E 2ND ST",
"address_2": "ESSENTIA HEALTH POLINSKY MEDICAL REHAB CENTER",
"city": "DULUTH",
"state": "MN",
"postal_code": "558051913",
"telephone_number": "218-786-5360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITNEY",
"first_name": "LAURA",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2016-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP 3078",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8753229-00",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Duluth, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.