NPIMap

Organization Active NPI

Meritcare 1219

  • Family Psychologist
  • Detroit Lakes, MN
National Provider Identifier
1871749036
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
Legal business name
MERITCARE 1219
Practice address
1219 S Washington Ave
Detroit Lakes, MN 56501-3905
Phone
(218) 846-2000
NPI assigned
Aug 7, 2008
Last updated
Aug 13, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Lisa M Carlson
Title
Cfo
Phone
701233344811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TF0000X Primary

Addresses

Primary practice location

1219 S Washington Ave
Detroit Lakes, MN 56501-3905

Mailing address

1219 S Washington Ave
Detroit Lakes, MN 56501-3905
Phone (218) 846-2000

National Provider Directory

National Provider Directory
Tax ID family
Meritcare Med GP Lamoure31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

Organizations that report the same tax identification number in the National Provider Directory.

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1871749036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1219 S WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1219 S WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013905",
            "telephone_number": "218-846-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITCARE 1219",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-07",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "701233344811"
    },
    "taxonomies": [
        {
            "code": "103TF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.