Dave Minden, PH.D.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

1812-057 Issued in WI

Practice address

702 N Blackhawk Ave Ste 104
Madison, WI 53705-3357

Phone

(608) 233-0657

Fax

(866) 746-7898

NPI assigned

Mar 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1952378754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4322 UPLAND DR",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537055041",
            "telephone_number": "608-233-0657",
            "fax_number": "866-746-7898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "702 N BLACKHAWK AVE STE 104",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537053357",
            "telephone_number": "608-233-0657",
            "fax_number": "866-746-7898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINDEN",
        "first_name": "DAVE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-01",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WI",
            "license": "1812-057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39105800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sandra M Milz, APNP
• Andra Ioana Mina, NP
• Mind and Match Wisconsin, S.C.
• Mind Evolution
• Mind Over Matter
• Mindful Growth Psychotherapy, LLC
• Mindful Healing Counseling LLC
• Mindful Motion Physical Therapy, LLC
• Madelyn L Minnick, APSW
• Nicole Minniti-Bohl, MS, CCC-SLP

• Counseling Psychologist in Madison, WI
• Providers in Madison, WI by specialty
• Counseling Psychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.