Dennis M. Brekke, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP1738 Issued in MN

Practice address

2021 E Hennepin Ave
Suite 411
Minneapolis, MN 55413-1896

Phone

(612) 991-1769

Fax

(612) 395-5585

NPI assigned

Sep 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

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.

• Suburban North Psychological Services, P.a.

  • Clinical Psychologist
  • Minneapolis, MN
  • NPI 1972727105
  NPD

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1508962960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10331 108TH PL N",
            "city": "MAPLE GROVE",
            "state": "MN",
            "postal_code": "553692638",
            "telephone_number": "763-424-4439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 E HENNEPIN AVE",
            "address_2": "SUITE 411",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554131896",
            "telephone_number": "612-991-1769",
            "fax_number": "612-395-5585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREKKE",
        "first_name": "DENNIS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP1738",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "546347500",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "01992BR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1H217BR",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patti Breen, PNP
• Larisa Anne Marie Breid, MSW
• Jenna L Breidinger, DNP, APRN, CNP
• Ada Breitenbucher
• James Robert Breitenbucher, MD
• Norman Brekke
• Michaela Marie Bremmer, CRNA, APRN
• Brianna Marie Bren, DPT
• Kari Elizabeth Brenberg, LICSW
• Brenda Baker Pac LLC

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.