Individual provider Active NPI

Claire Katherine Docherty Welsch, PHD, LP

  • Clinical Psychologist
  • Brooklyn Center, MN
National Provider Identifier
1629613351
Registry record updated Jul 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
4425 Issued in MN
Practice address
5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322
Phone
(763) 569-5200
Fax
(763) 569-5201
NPI assigned
Nov 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 4425 MN Primary

Addresses

Primary practice location

5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322

Mailing address

5910 Shingle Creek Pkwy
Brooklyn Center, MN 55430-2322
Phone (763) 569-5200

Other practice location 1

6425 Nicollet Ave
Richfield, MN 55423-1675
Phone (612) 861-1675

Other practice location 2

1001 Highway 7 Ste 309
Hopkins, MN 55305-4737
Phone (612) 861-1675

Other practice location 3

701 Decatur Ave N Ste 109
Golden Valley, MN 55427-4363
Phone (763) 746-2400

Other names 1

  • Claire Docherty Former name

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

LicenseStateTypeSpecialty
4425MNMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1574035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594080000000",
    "number": "1629613351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5910 SHINGLE CREEK PKWY",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302322",
            "telephone_number": "763-569-5200",
            "fax_number": "763-569-5201"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6425 Nicollet Ave",
            "address_purpose": "LOCATION",
            "city": "Richfield",
            "state": "MN",
            "postal_code": "554231675",
            "country_code": "US",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 Highway 7 Ste 309",
            "address_purpose": "LOCATION",
            "city": "Hopkins",
            "state": "MN",
            "postal_code": "553054737",
            "country_code": "US",
            "telephone_number": "612-861-1675",
            "fax_number": "612-861-3446",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Decatur Ave N Ste 109",
            "address_purpose": "LOCATION",
            "city": "Golden Valley",
            "state": "MN",
            "postal_code": "554274363",
            "country_code": "US",
            "telephone_number": "763-746-2400",
            "fax_number": "763-746-2401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WELSCH",
        "first_name": "CLAIRE",
        "middle_name": "KATHERINE DOCHERTY",
        "credential": "PHD, LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-18",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "4425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CLAIRE",
            "last_name": "DOCHERTY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brooklyn Center, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.