Individual provider Active NPI

Julianne Marie Davis, PSYD

  • Clinical Psychologist
  • Duluth, MN
National Provider Identifier
1659322915
Registry record updated Dec 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
LP4855 Issued in MN
Practice address
400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951
Phone
(218) 786-8364
NPI assigned
May 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X LP4855 MN Primary
Clinical Psychologist 103TC0700X 01001 IA

Addresses

Primary practice location

400 E 3Rd St
Essentia Health Duluth Clinic
Duluth, MN 55805-1951

Mailing address

400 E 3Rd St
McL2Cred
Duluth, MN 55805-1951
Phone (218) 786-8364

Other names 1

  • Ms. Julianne Marie Recknor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 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

Enrollment IDStateProvider typePAC IDDetails
I20080130000632 MN Practitioner - Clinical Psychologist 6709897929 Reassigns benefits to 2 organizations
I20190610000381 WI Practitioner - Clinical Psychologist 6709897929 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

Hospital & facility affiliations

  • Essentia Health Duluth Hospital, Duluth, MN, CCN 240019
  • St Marys Hospital Superior Hospital, Superior, WI, CCN 521329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0012KSMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic LTD CurrentSince Jun 29, 2015 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jun 29, 2015 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
St. Mary'S Hospital of Superior CurrentSince Jun 7, 2019 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
SMDC Medical Center CurrentSince Dec 17, 2018 Accepting new patients
Duluth Graduate Medical Education Council Inc Past Accepting new patients
SMDC Medical Center PastSince Dec 17, 2018 Accepting new patients
The Duluth Clinic, LTD Past Accepting new patients
Cowley County Mental Health Center Past Accepting new patients

Locations

400 E 3rd St
#6
Duluth, MN 55805
Phone (320) 360-1676

400 E 3rd St
#2
Duluth, MN 55805
Phone (218) 786-8319

502 E 2nd St
Duluth, MN 55805
Phone (218) 727-8762

4621 E Superior St
Duluth, MN 55804
Phone (218) 786-3550

935 Kenwood Ave
Duluth, MN 55811
Phone (218) 723-6408

2501 Rice Lake Rd
Duluth, MN 55811
Phone (218) 625-6400

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

615 Pecan Ave
Duluth, MN 55811
Phone (218) 355-2100

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

Organizations & group practices 12

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1544745600000",
    "number": "1659322915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "MCL2CRED",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "address_2": "ESSENTIA HEALTH DULUTH CLINIC",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JULIANNE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2018-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4855",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "01001",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIANNE",
            "last_name": "RECKNOR",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Duluth, MN

Sources for this page

Verify at the official NPI Registry.