Individual provider Active NPI

Julie Tilsen, M.A., LP

  • Psychologist
  • Minneapolis, MN
National Provider Identifier
1659476802
Registry record updated Jul 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP3522 Issued in MN
Practice address
3609 Harriet Ave
Minneapolis, MN 55409-1120
Phone
(612) 462-3707
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP3522 MN Primary

Addresses

Primary practice location

3609 Harriet Ave
Minneapolis, MN 55409-1120

Mailing address

3609 Harriet Ave
Minneapolis, MN 55409-1120
Phone (612) 462-3707

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LP3522MNMDPsychologist

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279238400000",
    "number": "1659476802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3609 HARRIET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091120",
            "telephone_number": "612-462-3707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3609 HARRIET AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554091120",
            "telephone_number": "612-462-3707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TILSEN",
        "first_name": "JULIE",
        "credential": "M.A., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2010-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP3522",
            "primary": true
        }
    ],
    "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 Jul 16, 2010; 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.