Lydia Gail Roth-Laube, PH.D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP2153 Issued in MN

Practice address

1660 Highway 100 S Ste 142
St Louis Park, MN 55416-1562

Phone

(952) 544-5719

Fax

(952) 544-5719

NPI assigned

Jan 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Clinical Psychologist

Education

University of Minnesota Medical School, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1169337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770636771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4006 CEDARWOOD RD",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554163823",
            "telephone_number": "952-927-4746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1660 HIGHWAY 100 S STE 142",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554161562",
            "telephone_number": "952-544-5719",
            "fax_number": "952-544-5719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTH-LAUBE",
        "first_name": "LYDIA",
        "middle_name": "GAIL",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP2153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela V. Ross, D.M.D.
• Anna A Ross
• Laura Joyce-Carlson Ross, PA-C
• Sarah Rae Rossall, MPA, PA-C
• Liv Rostad
• Hannah Williams Rothausen
• Michael Levy Rothschild, DPT
• Tom S Rotman
• Karen M Rowehl, RD
• Roy Krengel II PA (Krengel Dental)

• Clinical Psychologist in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.