Organization Active NPI

Martinsen Behavioral Health PLLC

  • Clinical Psychologist
  • Minot, ND
National Provider Identifier
1831844349
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
MARTINSEN BEHAVIORAL HEALTH PLLC
Practice address
2116 4TH Ave NW Ste 100
Minot, ND 58703-2967
Phone
(701) 838-2112
Fax
(701) 838-2115
NPI assigned
Feb 14, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Authorized official

Name
Dr. Della Ann Martinsen, PHDNPI 1760570998
Title
Licensed Psychologist
Phone
(701) 838-2112

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

2116 4TH Ave NW Ste 100
Minot, ND 58703-2967

Mailing address

2116 4TH Ave NW Ste 100
Minot, ND 58703-2967
Phone (701) 838-2112

Other identifiers 2

IdentifierTypeStateIssuer
N731150OtherNDMEDICARE
1485670MedicaidND

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address della@martinsenbehavioral.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220401001640 ND Part B Supplier - Clinic/Group Practice 2466848304 Receives reassigned benefits from 1 practitioner
Practice locations: Minot, ND

National Provider Directory

National Provider Directory

Locations

2116 4th Ave NW
Ste 100
Minot, ND 58703
Phone (701) 838-2112

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678838400000",
    "number": "1831844349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 4TH AVE NW STE 100",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032967",
            "telephone_number": "701-838-2112",
            "fax_number": "701-838-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2116 4TH AVE NW STE 100",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587032967",
            "telephone_number": "701-838-2112",
            "fax_number": "701-838-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTINSEN BEHAVIORAL HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A",
        "authorized_official_last_name": "MARTINSEN",
        "authorized_official_first_name": "DELLA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "701-838-2112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "N731150",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1485670",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "della@martinsenbehavioral.com",
            "affiliation": "N",
            "endpointDescription": "business email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2116 4th Ave NW Ste 100",
            "city": "Minot",
            "state": "ND",
            "country_code": "US",
            "postal_code": "587032967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.