Active NPI
Linda Atwood, PSYD, LP
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1336212976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP4264
- Practice address
- 3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527 - Phone
- (612) 925-6033
- Fax
- (612) 925-8496
- NPI assigned
- Nov 15, 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 | LP4264 | MN | Primary |
Addresses
Primary practice location
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527
Mailing address
3100 W Lake St
Suite 210
Minneapolis, MN 55416-4527
Phone (612) 925-6033
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680015850 | Other | MN | RR MEDICARE |
| HP34487 | Other | MN | HEALTHPARTNERS |
| 672657700 | Medicaid | MN | |
| 50G04G0 | Other | MN | BCBS |
| 170662C154 | Other | MN | UCARE |
| 2029601 | Other | MN | BHP |
| 6164076 | Other | MN | MEDICA CHOICE |
Other names 1
- Linda Goldetsky
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 |
|---|---|---|---|
| LP4264 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1336212976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 W LAKE ST",
"address_2": "SUITE 210",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164527",
"telephone_number": "612-925-6033",
"fax_number": "612-925-8496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3100 W LAKE ST",
"address_2": "SUITE 210",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554164527",
"telephone_number": "612-925-6033",
"fax_number": "612-925-8496"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATWOOD",
"first_name": "LINDA",
"credential": "PSYD, LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-15",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP4264",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "680015850",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS",
"identifier": "HP34487",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "672657700",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "50G04G0",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "170662C154",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BHP",
"identifier": "2029601",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA CHOICE",
"identifier": "6164076",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LINDA",
"last_name": "GOLDETSKY",
"code": "1",
"type": "Former Name"
}
]
}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 Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.