Wanda J Dahlen, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

LP4577 Issued in MN

Practice address

928 8TH St SE
Detroit Lakes, MN 56501-2839

Phone

(218) 847-1676

NPI assigned

Jul 16, 2015

Last updated

Mar 17, 2016By 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 names 1

• Dr. Wanda J McSparron Former name

Medicare fee-for-service enrollment

Enrolled in MN

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 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeland Mental Health Center IncGroup PAC ID 1759291891, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeland Mental Health Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fergus Falls, MN
  • NPI 1366480287
  Medicare reassignment Care Compare group NPD
• Lakeland Mental Health Center

  • Case Manager/Care Coordinator
  • Fergus Falls, MN
  • NPI 1063869055
  NPD (past)

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

{
    "created_epoch": "1437004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458172800000",
    "number": "1881078145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 8TH ST SE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565012839",
            "telephone_number": "218-847-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "928 8TH ST SE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565012839",
            "telephone_number": "218-847-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHLEN",
        "first_name": "WANDA",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-16",
        "last_updated": "2016-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP4577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "MCSPARRON",
            "middle_name": "J",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michelle Dawn Crissinger, APRN, CNP
• Anthony J Crow
• Marna M Crow, CNM
• Jeremiah Dagel, PA
• Jenae Allison Daggett, OTR/L
• Dakota Clinic LTD (Dakota Clinic Ambulatory Surgery Center)
• Dakota Clinic LTD (Dakota Clinic LTD Detroit Lakes)
• Dakota Clinic, LTD. (Dakota Clinic, Ltd. - Detroit Lakes)
• Dakota Clinic, LTD. (Dakota Clinic, LTD. Detroit Lakes)
• Dale Hoffmann, P.C.

• Counseling Psychologist in Detroit Lakes, MN
• Providers in Detroit Lakes, MN by specialty
• Counseling Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2016; 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.