Individual provider Active NPI

Patricia Jean Aletky, PH.D., LP

  • Psychologist
  • Golden Valley, MN
National Provider Identifier
1720012768
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
LP1903 Issued in MN
Practice address
4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone
(763) 588-0661
Fax
(763) 302-4065
NPI assigned
Jul 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X LP1903 MN Primary

Addresses

Primary practice location

4225 Golden Valley Rd
Golden Valley, MN 55422-4215

Mailing address

4225 Golden Valley Rd
Golden Valley, MN 55422-4215
Phone (763) 588-0661

Other identifiers 6

IdentifierTypeStateIssuer
39140100MedicaidWI
0265030OtherMNPREFERRED ONE
14634ALOtherMNBCBS OF MN
6129145OtherMNMEDICA
HP20529OtherMNHEALTHPARTNERS
24875OtherMNAMERICA'S PPO

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
LP1903MNMDPsychologist

NPI Registry JSON

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": "1720012768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224215",
            "telephone_number": "763-588-0661",
            "fax_number": "763-302-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 GOLDEN VALLEY RD",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554224215",
            "telephone_number": "763-588-0661",
            "fax_number": "763-302-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALETKY",
        "first_name": "PATRICIA",
        "middle_name": "JEAN",
        "credential": "PH.D., LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP1903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39140100",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "0265030",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MN",
            "identifier": "14634AL",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "6129145",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP20529",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICA'S PPO",
            "identifier": "24875",
            "state": "MN"
        }
    ],
    "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 Jul 9, 2007; 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.