Active NPI
John T Landry
- Counseling Psychologist
- Minneapolis, MN
National Provider Identifier
1891122628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- LP2942
- Practice address
- 5325 Grand Ave S
Minneapolis, MN 55419-1358 - Phone
- (612) 226-2785
- NPI assigned
- Oct 11, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | LP2942 | MN | Primary |
Addresses
Primary practice location
5325 Grand Ave S
Minneapolis, MN 55419-1358
Mailing address
5325 Grand Ave S
Minneapolis, MN 55419-1358
Phone (612) 226-2785
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP2942 | MN | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381449600000",
"number": "1891122628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5325 GRAND AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554191358",
"telephone_number": "612-226-2785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5325 GRAND AVE S",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554191358",
"telephone_number": "612-226-2785"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LANDRY",
"first_name": "JOHN",
"middle_name": "T",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-11",
"last_updated": "2013-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "LP2942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.