NPIMap

Organization Active NPI

Lakeville Behavioral Health, LLC

  • Cognitive & Behavioral Psychologist
  • Lakeville, MN
National Provider Identifier
1750412680
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cognitive & Behavioral PsychologistTaxonomy code 103TB0200X
License
LP3587 Issued in MN
Legal business name
LAKEVILLE BEHAVIORAL HEALTH, LLC
Practice address
10535 165TH St W
Lakeville, MN 55044-5729
Phone
(952) 435-0022
Fax
(952) 435-0095
NPI assigned
Mar 9, 2007
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Dale Knute Lokkesmoe, M.A.NPI 1558437764
Title
Licensed Psychologist
Phone
(952) 435-0022

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cognitive & Behavioral PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TB0200X LP3587 MN Primary
Cognitive & Behavioral PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TB0200X LP1249 MN

Addresses

Primary practice location

10535 165TH St W
Lakeville, MN 55044-5729

Mailing address

10535 165TH St W
Lakeville, MN 55044-5729
Phone (952) 435-0022

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1750412680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10535 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445729",
            "telephone_number": "952-435-0022",
            "fax_number": "952-435-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 165TH ST W",
            "city": "LAKEVILLE",
            "state": "MN",
            "postal_code": "550445729",
            "telephone_number": "952-435-0022",
            "fax_number": "952-435-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKEVILLE BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "LOKKESMOE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "KNUTE",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "952-435-0022",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "LP3587",
            "primary": true
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "MN",
            "license": "LP1249",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.