Brenda J King, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

357 Issued in ND

Practice address

2808 17TH Ave S
Grand Forks, ND 58201-4010

Phone

(701) 746-8376

Fax

(701) 746-9872

NPI assigned

Jul 10, 2006

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in MN, ND2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Clinical Psychologist

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lipp Carlson Witucki and Associates LTDGroup PAC ID 2062408701, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Lipp, Carlson, Witucki & Associates, LTD

  • Clinical Psychologist
  • Grand Forks, ND
  • NPI 1043316961
  Medicare reassignment Care Compare group NPD
• Riverview Healthcare Association

  • Multi-Specialty Clinic/Center
  • East Grand Forks, MN
  • NPI 1811918436
  NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1598799892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-746-8376",
            "fax_number": "701-746-9872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2808 17TH AVE S",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582014010",
            "telephone_number": "701-746-8376",
            "fax_number": "701-746-9872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "BRENDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ND",
            "license": "357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12052",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel G Kiefat, DC
• Amanda Kiefer
• Leanne Kilzer, FNP-C
• Kindred Care LLC
• Alan Russell King, PH.D.
• Erin Elizabeth King, M.D.
• Melody Sue King
• Robert King, MD
• Selena King
• Julie Kinneberg

• Clinical Psychologist in Grand Forks, ND
• Providers in Grand Forks, ND by specialty
• Clinical Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.