Active NPI
Mark Huttemier, LPP
- Counseling Psychologist
- Golden Valley, MN
National Provider Identifier
1619134574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LPP 0117
- Practice address
- 3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422 - Phone
- (763) 520-0516
- NPI assigned
- May 19, 2008
- Sex
- Male
- Sole proprietor
- No
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 | LPP 0117 | MN | Primary |
Addresses
Primary practice location
3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422
Mailing address
3915 Golden Valley Road
Courage Center
Golden Valley, MN 55422
Phone (763) 520-0516
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
| License | State | Type | Specialty |
|---|---|---|---|
| LPP 0117 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1619134574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY ROAD",
"address_2": "COURAGE CENTER",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "55422",
"telephone_number": "763-520-0516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3915 GOLDEN VALLEY ROAD",
"address_2": "COURAGE CENTER",
"city": "GOLDEN VALLEY",
"state": "MN",
"postal_code": "55422",
"telephone_number": "763-520-0516"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUTTEMIER",
"first_name": "MARK",
"credential": "LPP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LPP 0117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Golden Valley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.