Active NPI
Ellen Lowery, PH.D., LP
- Clinical Psychologist
- Brooklyn Park, MN
National Provider Identifier
1730193954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 00091
- Practice address
- 7600 Boone Ave N
Suite 2
Brooklyn Park, MN 55428-4563 - Phone
- (763) 515-2450
- NPI assigned
- Jul 27, 2006
- Last updated
- Jul 18, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 00091 | MN | Primary |
Addresses
Primary practice location
7600 Boone Ave N
Suite 2
Brooklyn Park, MN 55428-4563
Mailing address
7600 Boone Ave N
Suite 2
Brooklyn Park, MN 55428-4563
Phone (763) 515-2450
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 148951 | Other | MN | CP |
| 26D11LO | Other | MN | BCBS |
| 21266 | Other | MN | HP |
| 512716500 | Medicaid | MN | |
| 1012053 | Other | MN | P1 |
| 114927 | Other | MN | UC |
| 61-52204 | Other | MN | UBH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 00091 | MN | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405641600000",
"number": "1730193954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7600 BOONE AVE N",
"address_2": "SUITE 2",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554284563",
"telephone_number": "763-515-2450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7600 BOONE AVE N",
"address_2": "SUITE 2",
"city": "BROOKLYN PARK",
"state": "MN",
"postal_code": "554284563",
"telephone_number": "763-515-2450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOWERY",
"first_name": "ELLEN",
"name_prefix": "Dr.",
"credential": "PH.D., LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-27",
"last_updated": "2014-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "00091",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CP",
"identifier": "148951",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "26D11LO",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HP",
"identifier": "21266",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "512716500",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "P1",
"identifier": "1012053",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UC",
"identifier": "114927",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UBH",
"identifier": "61-52204",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn Park, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.