Active NPI
Meredith Anne Martyr, PHD
- Counseling Psychologist
- New Brighton, MN
National Provider Identifier
1437828894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP6518
- Practice address
- 515 Mission House Lane
New Brighton, MN 55112 - Phone
- (651) 636-5120
- NPI assigned
- Sep 9, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP6518 | MN | Primary |
Addresses
Primary practice location
515 Mission House Lane
New Brighton, MN 55112
Mailing address
916 Lincoln Ave
Minneapolis, MN 55403-3049
Phone (651) 246-0721
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP6518 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1631145600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631145600000",
"number": "1437828894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "916 LINCOLN AVE",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554033049",
"telephone_number": "651-246-0721"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 MISSION HOUSE LANE",
"city": "NEW BRIGHTON",
"state": "MN",
"postal_code": "55112",
"telephone_number": "651-636-5120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTYR",
"first_name": "MEREDITH",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-09",
"last_updated": "2021-09-09",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP6518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Brighton, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.