Active NPI
Michael K Huntley, MA LP
- Psychologist
- Stillwater, MN
National Provider Identifier
1316059074
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP0420
- Practice address
- 101 W Pine St
Stillwater, MN 55082 - Phone
- (651) 439-8800
- Fax
- (651) 439-1040
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- 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 | LP0420 | MN | Primary |
Addresses
Primary practice location
101 W Pine St
Stillwater, MN 55082
Mailing address
101 W Pine St
Stillwater, MN 55082
Phone (651) 439-8800
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A3K670HU | Other | MN | BCBS |
| 13K671HU | Other | MN | BCBS |
| 411333578002 | Other | MN | CHAMPUS TRI-CARE |
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP0420 | MN | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Youth Service Bureau 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.
-
- Counselor
- Stillwater, MN
- NPI 1528164852
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1316059074",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 W PINE ST",
"city": "STILLWATER",
"state": "MN",
"postal_code": "55082",
"telephone_number": "651-439-8800",
"fax_number": "651-439-1040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W PINE ST",
"city": "STILLWATER",
"state": "MN",
"postal_code": "55082",
"telephone_number": "651-439-8800",
"fax_number": "651-439-1040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUNTLEY",
"first_name": "MICHAEL",
"middle_name": "K",
"credential": "MA LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP0420",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "A3K670HU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "13K671HU",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS TRI-CARE",
"identifier": "411333578002",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stillwater, 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.