Alva Dyrud, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1195 Issued in MN

Practice address

910 Lincoln Ave
Detroit Lakes, MN 56501-3500

Phone

(218) 844-5689

Fax

(218) 844-5689

NPI assigned

May 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871705186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 12TH AVE S",
            "city": "MOORHEAD",
            "state": "MN",
            "postal_code": "565603614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 LINCOLN AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013500",
            "telephone_number": "218-844-5689",
            "fax_number": "218-844-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYRUD",
        "first_name": "ALVA",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMN",
            "identifier": "12N24DY",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "HP71178",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Marriage & Family Therapist 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.