Active NPI
Angela Mary Loecke, PHD
- Clinical Psychologist
- Austin, MN
National Provider Identifier
1861625071
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP5152
- Practice address
- 430 10TH St NE Ste 3
Austin, MN 55912-3724 - Phone
- (507) 433-9120
- Fax
- (507) 457-3027
- NPI assigned
- Sep 3, 2009
- 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 | LP5152 | MN | Primary |
Addresses
Primary practice location
430 10TH St NE Ste 3
Austin, MN 55912-3724
Mailing address
PO Box 366
Austin, MN 55912-0366
Phone (507) 433-9120
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595462400000",
"number": "1861625071",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 366",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559120366",
"telephone_number": "507-433-9120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "430 10TH ST NE STE 3",
"city": "AUSTIN",
"state": "MN",
"postal_code": "559123724",
"telephone_number": "507-433-9120",
"fax_number": "507-457-3027"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOECKE",
"first_name": "ANGELA",
"middle_name": "MARY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-03",
"last_updated": "2020-07-23",
"certification_date": "2020-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP5152",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.