Individual provider Active NPI

Mych-Jarrod Dallozzi, PSYD, NCC, LPCC

  • Counseling Psychologist
  • Minneapolis, MN
National Provider Identifier
1558828251
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
3412 W 32ND St
Minneapolis, MN 55416-4606
Phone
(724) 299-1247
NPI assigned
Feb 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X Primary
Professional Counselor 101YP2500X 5190 MN
Professional Counselor 101YP2500X 200579837 PA

Addresses

Primary practice location

3412 W 32ND St
Minneapolis, MN 55416-4606

Mailing address

4317 Upton Ave S Ste a
Minneapolis, MN 55410-1540
Phone (724) 299-1247

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
5190MNMDProfessional Counselor
200579837PAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Psychological Growth and Resilience PastSince Dec 10, 2023 Accepting new patients

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": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772409600000",
    "number": "1558828251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4317 UPTON AVE S STE A",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101540",
            "telephone_number": "724-299-1247",
            "fax_number": "651-377-4336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3412 W 32ND ST",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554164606",
            "telephone_number": "724-299-1247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLOZZI",
        "first_name": "MYCH-JARROD",
        "credential": "PSYD, NCC, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-28",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "5190",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "200579837",
            "primary": false
        }
    ],
    "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 Mar 2, 2026; 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.