Active NPI
Brent Allan Betterley, LP
- Psychologist
- Minneapolis, MN
National Provider Identifier
1326194424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP0259
- Practice address
- 800 E 28TH St
Minneapolis, MN 55407-3723 - Phone
- (612) 863-8511
- NPI assigned
- Jan 25, 2007
- Last updated
- Jul 8, 2007
- 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 | LP0259 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St
Minneapolis, MN 55407-3723
Mailing address
4420 278TH St. W.
Castle Rock, MN 55010-0493
Phone (651) 460-6881
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP0259 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326194424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4420 278TH ST. W.",
"city": "CASTLE ROCK",
"state": "MN",
"postal_code": "550100493",
"telephone_number": "651-460-6881",
"fax_number": "612-863-8516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073723",
"telephone_number": "612-863-8511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BETTERLEY",
"first_name": "BRENT",
"middle_name": "ALLAN",
"name_prefix": "Mr.",
"credential": "LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP0259",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
- Better Balance Psychological Services, LLC (Better Balance Psychology)
- Better Care Inc
- Better Fit Psychology & Consulting
- Better Hand Community and Health Services LLC
- Better Life Care Autism Center LLC
- Tracy Rebecca Betterley, PHARM.D
- Gwen G Betterman, PHARMD
- Betterworld Behavioral Health LLC
- Michelle Lee Bettin, LICSW
- Annette Sue Betts, FNP
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.