Individual provider Active NPI

Denise M Tromblay

  • Clinical Psychologist
  • Minneapolis, MN
National Provider Identifier
1376520304
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP3966 Issued in MN
Practice address
3507 Lyndale Ave S
Minneapolis, MN 55408-4159
Phone
(612) 849-0484
NPI assigned
Dec 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP3966 MN Primary

Addresses

Primary practice location

3507 Lyndale Ave S
Minneapolis, MN 55408-4159

Mailing address

3531 Lyndale Ave S
Minneapolis, MN 55408-4161

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

LicenseStateTypeSpecialty
LP3966MNMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychotherapy Partners, LLC Current Accepting new patients

Locations

3507 Lyndale Ave S
Minneapolis, MN 55408
Phone (612) 702-4119

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.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1376520304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3507 LYNDALE AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084159",
            "telephone_number": "612-849-0484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLAY",
        "first_name": "DENISE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP3966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 31, 2008; 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.