Nancy K Bottorff, LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

LP4674 Issued in MN

Practice address

3108 Hennepin Ave
Minneapolis, MN 55408-2619

Phone

(612) 590-7572

NPI assigned

Jan 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, HI2 enrollments

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 2

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Ho'Oulu Counseling LLCGroup PAC ID 5991038150, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ho'Oulu Counseling LLC

  • Marriage & Family Therapist
  • Kailua Kona, HI
  • NPI 1528556966
  Medicare reassignment Care Compare group NPD
• Hamm Memorial Psychiatric Clinic

  dba Hamm Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saint Paul, MN
  • NPI 1609876051
  NPD (past)
• Relate Inc

  dba Relate

  • Community/Behavioral Health Agency
  • Minnetonka, MN
  • NPI 1053486902
  NPD (past)
• Sarah L. Hart, PH.D., LLC

  dba Sarah L Hart, PhD, LP

  • Counseling Psychologist
  • Saint Paul, MN
  • NPI 1285935064

  Clinical

  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1780733774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3927 THOMAS AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101235",
            "telephone_number": "612-207-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3108 HENNEPIN AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082619",
            "telephone_number": "612-590-7572"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75-5995 Kuakini Hwy Ste 221",
            "address_purpose": "LOCATION",
            "city": "Kailua Kona",
            "state": "HI",
            "postal_code": "967402120",
            "country_code": "US",
            "telephone_number": "612-207-0090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOTTORFF",
        "first_name": "NANCY",
        "middle_name": "K",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "HI",
            "license": "PSY-1910",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP4674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ahmed Jama Botan
• Both Sides Counseling
• Barbara Botorous
• Jack George Soliman Botros, DDS, MS
• Rachel Elizabeth Bottcher, APRN, CRNA
• Christina Leah Botts
• Andria Botzet, LMFT
• Carl Fouad Bou-Abboud, DO
• Laura Bou-Maroun, MD
• Alexander Albert Boucher, MD

• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.