Carolyn Disch LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

CAROLYN DISCH LLC

Practice address

8120 Penn Ave S Ste 500F
Bloomington, MN 55431-1367

Phone

(612) 325-6904

NPI assigned

Feb 15, 2023

Last updated

Feb 15, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carolyn E Disch, LICSWNPI 1649910985

Title

Therapist

Phone

(612) 325-6904

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolyn Disch, LICSW

  • Clinical Social Worker
  • Edina, MN
  • NPI 1649910985
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676419200000",
    "number": "1366149775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 PENN AVE S STE 500F",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311367",
            "telephone_number": "612-325-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8120 PENN AVE S STE 500F",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554311367",
            "telephone_number": "612-325-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN DISCH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-02-15",
        "certification_date": "2023-02-15",
        "status": "A",
        "authorized_official_last_name": "DISCH",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "612-325-6904",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1649910985",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nikole M. Carlson, D.C.
• Rhys Joel Carlson
• Richard Carlson, M.D.
• Carol Jo Otter Ladd Psychotherapy and Consulting LLC
• Jennifer Lee Carolan, M.D.
• Emmett Franklin Carpel, MD
• Cole Carper
• Jennifer Fromm Carroll, MD
• Lauren T Carroll, MD
• Emma Carter

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.